Pancreatic injuries in children

Aims: There are several different philosophies in the diagnostics of blunt abdominal trauma (BAT), yet none of them has been shown to be superior, alt hough enhanced computed tomography (CT) and diagnostic ultrasonography (US) seem to be the most used methods today. Treatment of pancreatic injury (PI ) in children is a matter of controversy, whether operative treatment is ne eded and to what extent. Material and Methods: Seventeen pancreatic injuries were found in a retrosp ective analysis of 111 paediatric patients, aged 2-14 years, who underwent a laparotomy because of BAT, between 1968 and 1995 in Turku University Cent ral Hospital. The number of non-operated BAT patients was calculated as 287 . Results: During the past two decades, the number of BATs and operations dim inished by more than two thirds, but the number of PIs remained the same. T welve acute operations led to four pancreatic resections, two external drai nages and two explorations. PI was present but not the main reason for oper ation in four cases. Five PIs were operated on later due to postraumatic ps eudocyst of the pancreas. Conclusions: PI was rare (15%) in laparotomies done because of BAT, operati ons which have diminished by 74% during the last twenty years. When PI was found, a variety of operative procedures was needed.