Ruszinkó V, Willner P, Oláh A
Department of Pediatrics, Petz Aladár County Teaching Hospital, Gyor, Hungary.
Acta Chir Belg. 2005 May-Jun;105(3):283-6. doi: 10.1080/00015458.2005.11679717.
Pancreatic trauma in children is relatively uncommon, but carries high morbidity and mortality rates when diagnosis is delayed. Preoperative diagnosis of pancreatic lesion might be difficult, especially in the case of isolated injury.
Authors analyse seven cases of pancreatic trauma in childhood. In three cases surgical intervention was required due to pancreatic transection with main pancreatic duct rupture. The injuries of the 5-10 years old male patients were diagnosed and operated on within 24 hours.
In two cases distal resection were performed with splenic preservation. In one case--where the operation was performed within 8 hours--preservation of the distal pancreas was also achieved by distal pancreatogastrostomy. The postoperative period was uneventful in all cases. Impaired glucose metabolism was not found in the operated cases during the follow up.
Authors emphasise the importance of CT scan and the responsibility of the first attending physician regarding both diagnosis and correct surgical management.
儿童胰腺创伤相对少见,但诊断延迟时发病率和死亡率较高。胰腺损伤的术前诊断可能困难,尤其是在孤立损伤的情况下。
作者分析了7例儿童胰腺创伤病例。3例因胰腺横断伴主胰管破裂而需要手术干预。5至10岁男性患者的损伤在24小时内得到诊断并接受手术。
2例行保留脾脏的远端切除术。1例在8小时内进行手术,通过远端胰胃吻合术也实现了远端胰腺的保留。所有病例术后恢复顺利。随访期间手术病例未发现糖代谢受损。
作者强调CT扫描的重要性以及首诊医生在诊断和正确手术管理方面的责任。