Title: Isolated Pediatric Pancreatic Transection Secondary to Ocean-Related Trauma | Insight Medical Publishing
Headings: Isolated Pediatric Pancreatic Transection Secondary to Ocean-Related Trauma
Isolated Pediatric Pancreatic Transection Secondary to Ocean-Related Trauma
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Abstract
Keywords
INTRODUCTION
CASE REPORT
DISCUSSION
Acknowledgments
Conflict of interest
Financial support
References

Content: The presence of lesser sac hematoma, pre-pancreatic edema, obscured pancreatic duodenal interface, and non-visualization of the extra-pancreatic vessels should increase suspicion of pancreatic injury [ 5 ]. Repeat CT scans 24 hours after injury have been advocated when clinical suspicion persists and definitive diagnosis remains elusive [ 4, 7 ]. Endoscopic retrograde cholangiopancreatography can be used for further delineation of duct injury if unclear with CT [ 9, 10 ]. The benefit of serum markers such as amylase and lipase to aid in evaluation or management of pancreatic injury has been controversial. Elevated serum amylase and lipase are common with pancreatic injuries but not pathognomonic, nor is the degree of elevation of these enzymes necessarily indicative of the extent of injury [ 4 ]. It has been suggested that amylase and lipase are not cost-effective screening tools for pediatric pancreatic trauma and that routine repeat amylase and lipase levels are of limited value [ 3, 11 ]. Other literature suggests that delayed amylase levels or degree of amylase elevation can be reflective of pancreatic injury, or may be useful when imaging is inconclusive or in children with persistent unexplained abdominal pain [ 5, 6, 12, 13 ]. Lesion to the pancreas is typically caused by blunt trauma to the epigastrium, which compresses the pancreas against the vertebral column, resulting in crush or transection injuries. The major causes of pancreatic injury described involve motor vehicle crash, bicycle accident, all-terrain vehicles accident, assault, or fall [ 14 ]. Potential complications include intra-abdominal abscess, pancreatic fistula, pseudocyst and post-traumatic pancreatitis [ 15 ].