CHARACTERISTICS OF PANCREATIC INJURY IN CHILDREN - A COMPARISON WITH SUCH INJURY IN ADULTS

A retrospective study of eight pediatric patients (under 15 years of a ge) who had pancreatic injuries was undertaken. Comparisons were made with 59 adult patients who sustained pancreatic injuries over the same 18 year period. All the pediatric injuries and 96.6% of the adult res ulted from blunt abdominal trauma. Bicycle accidents (children, 75.0%; adults, 0%; P < .001) and automobile accidents (children, 0%; adults, 61.0%; P < .01) were the most common causes of pancreatic injury in t he two groups. There was no significant difference in the incidence of abdominal pain or peritoneal irritation between the groups. However, abdominal pain in the adults was poorly localized. Isolated pancreatic injuries were noted in 62.5% of the pediatric patients and in 15.3% o f the adult patients (P < .05). Associated intraabdominal injuries wer e present in 25.0% of the children and in 69.5% of the adults (P < .05 ). The duodenum was injured in two (25.0%) pediatric patients and in 1 0 (16.9%) adult patients. Whereas the duodenal injuries in pediatric p atients were intramural hematomas without perforation in both cases, a ll but one of these injuries in adults were perforations or transectio ns (P < .05). There was a significant difference in the type of pancre atic injury between the two groups (P < .05). Surgery was performed in 12.5% of the pediatric cases and in 78.0% of the adult cases (P < .01 ). There were no deaths among the pediatric patients, but 8.5% of the adults died in the hospital. The difference with respect to clinical c ourse might be related to the differences in cause of injury. Copyrigh t (C) 1996 by W.B. Saunders Company