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Poster Display - 136
Pediatric Pancreatic Trauma: A Case Series Highlighting Diagnostic Challenges and the Role of Minimally Invasive Management
Arije Zouaoui, Ameni Missaoui, Yasmine Houas, Yosra Kerkeni, Riadh Jouini, Said Jlidi
Children's Hospital Bechir Hamza, Tunis, Tunisia
Introduction:
Pancreatic trauma in children is an uncommon but potentially severe condition, primarily resulting from blunt abdominal trauma. The retroperitoneal location of the pancreas and the non-specific nature of early symptoms often delay diagnosis, increasing the risk of complications. Prompt identification and tailored management are essential to reduce morbidity and optimize outcomes.
Case Series:
We report five cases of pediatric pancreatic trauma illustrating diverse mechanisms, injury severity, and management strategies.
Three 11-year-old boys sustained high-grade pancreatic body fractures following, respectively, two crush injuries and blunt abdominal trauma from a bicycle handlebar. They developed large peripancreatic fluid collections (16,18 and 20 cm), successfully managed with percutaneous CT-guided transgastric drainage and antibiotics, leading to favorable recovery after 45 days.
A 10-year-old boy suffered a corporocaudal pancreatic fracture after a fall onto a stone, complicated by a 17 cm fluid collection. Image-guided transgastric drainage allowed clinical and radiological improvement.
Two girls (2 and 4 years old) presented with a Grade III pancreatic body fracture following respectively a motor vehicle collision and a fall onto a chair, associated with pulmonary and pelvic injuries for the first one. The stable 7 cm and 8cm peripancreatic collection resolved without invasive intervention, supported by close monitoring and normalization of serum lipase levels.
Conclusion:
Pediatric pancreatic trauma remains a diagnostic and therapeutic challenge due to its rarity and non-specific presentation. This case series emphasizes the variability of injury patterns and highlights the importance of early imaging, careful ductal assessment, and personalized, often minimally invasive, management strategies to reduce morbidity and improve outcomes