Nonoperative management of pancreatic injuries in pediatric patients

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dc.contributor.authorCigdem, Murat Kemal
dc.contributor.authorSenturk, Senem
dc.contributor.authorOnen, Abdurrahman
dc.contributor.authorSiga, Mesut
dc.contributor.authorAkay, Hatice
dc.contributor.authorOtcu, Selcuk
dc.date.accessioned2024-04-24T16:01:56Z
dc.date.available2024-04-24T16:01:56Z
dc.date.issued2011
dc.departmentDicle Üniversitesien_US
dc.description.abstractNonoperative management of minor pancreatic injury is the generally accepted approach. However, the management of major pancreatic injury remains controversial in pediatric patients. The aim of the present study was to determine the safety and efficacy of nonoperative management of pancreatic injury in pediatric patients. Between 2003 and 2009, 31 patients, 28 male and 3 female, with pancreatic injury due to blunt abdominal trauma were treated in our clinic. All patients were evaluated by ultrasonography, computed tomography (CT), and evaluation of serum amylase levels. Patients with ongoing hemodynamic instability after resuscitation or signs of bowel perforation underwent immediate laparotomy, and the remaining patients were conservatively treated. Conservative treatment consisted of nasogastric tube replacement, total parenteral nutrition, monitoring of amylase levels, and serial clinical examination. The most common mechanism of injury was a fall (35.4%). Ten patients (32.2%) had associated extraabdominal injuries, and 18 patients (58.1%) had associated abdominal injuries. The spleen was the most common site of intra-abdominal injury that was associated with pancreatic trauma. Initial amylase levels were normal in 5 patients, whose CT scans revealed pancreatic injury. Twenty-five patients (80.6%) were conservatively treated. Six patients (19.4%) required surgical intervention because of a hollow viscus or diaphragmatic injury and hemodynamic instability. A pseudocyst developed in 11 of the 25 patients who were nonoperatively treated; 6 patients required intervention for the pseudocyst (percutaneous drainage and cystogastrostomy). No patient succumbed to injury. The majority of the pancreatic injuries in pediatric patients can be successfully treated conservatively, unless there is hemodynamic instability and a hollow viscus injury. The most common complication is a pseudocyst.en_US
dc.identifier.doi10.1007/s00595-010-4339-4
dc.identifier.endpage659en_US
dc.identifier.issn0941-1291
dc.identifier.issn1436-2813
dc.identifier.issue5en_US
dc.identifier.pmid21533937
dc.identifier.scopus2-s2.0-79956213566
dc.identifier.scopusqualityQ1
dc.identifier.startpage655en_US
dc.identifier.urihttps://doi.org/10.1007/s00595-010-4339-4
dc.identifier.urihttps://hdl.handle.net/11468/14513
dc.identifier.volume41en_US
dc.identifier.wosWOS:000290036000009
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofSurgery Today
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectPancreatic Injuryen_US
dc.subjectNonoperative Managementen_US
dc.subjectPediatric Traumaen_US
dc.subjectPseudocysten_US
dc.titleNonoperative management of pancreatic injuries in pediatric patientsen_US
dc.titleNonoperative management of pancreatic injuries in pediatric patients
dc.typeArticleen_US

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