Management of blunt pancreatic injury in children. J Trauma 1999 Dec;47(6):1098-103
Date
12/23/1999Pubmed ID
10608540DOI
10.1097/00005373-199912000-00020Scopus ID
2-s2.0-0033436319 (requires institutional sign-in at Scopus site) 55 CitationsAbstract
BACKGROUND AND METHODS: Controversy persists regarding the management of pancreatic transection. Over the past 10 years, 51 patients admitted to the Children's Hospital of Pittsburgh sustained blunt pancreatic injuries. We reviewed their medical records to clarify the optimal management strategy and to define distinguishing characteristics, if any, of patients with pancreatic transection.
RESULTS: Patients who sustained pancreatic transection had a significantly higher Injury Severity Score, length of stay, serum amylase, and serum lipase, than those patients who sustained pancreatic contusion. Patients who underwent laparotomy within 48 hours of injury for pancreatic transection had a significantly shorter length of stay than those who underwent laparotomy more than 48 hours after injury.
CONCLUSION: Serum amylase greater than 200 and serum lipase greater than 1,800 may be useful clinical markers for major pancreatic ductal injury when combined with physical examination. Early operative intervention for pancreatic transection results in shorter length of stay and fewer complications.
Author List
Nadler EP, Gardner M, Schall LC, Lynch JM, Ford HRAuthor
Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Age FactorsAlgorithms
Amylases
Biomarkers
Child
Decision Trees
Female
Humans
Injury Severity Score
Length of Stay
Lipase
Logistic Models
Male
Pancreas
Pancreatectomy
Pancreaticojejunostomy
Patient Selection
Retrospective Studies
Treatment Outcome
Wounds, Nonpenetrating