Traumatic pancreatitis: Long-term review of initial non-operative management in children

Objective: To assess the safety and long-term efficacy of an initial non-op erative approach to the management of pancreatic trauma in children. Methodology: Retrospective case-note review of children admitted to our ins titution with the diagnosis of pancreatic trauma over a 10-year period from 1985 to 1994 inclusive. Results: Fourteen children were identified with a diagnosis of traumatic pa ncreatitis. Eleven of the injuries were secondary to motor vehicle accident s or trauma from a bicycle handlebar. In seven patients there were associat ed intra-abdominal injuries and in eight patients the traumatic pancreatiti s was complicated by development of a pseudocyst. Three pseudocysts settled without intervention, two resolved with percutaneous external drainage and the remaining three required open surgery. The mean in-patient stay was 21 .2 days. The average length of follow-up was 7.7 years with no observed lon g-term complications. Conclusions: Non-operative management of traumatic pancreatitis in the abse nce of complete duct transection is safe in children and does not appear to be associated with adverse sequelae.