Al Kuddoos Nabil Muhammad, Ismail Ahmad Khaldun, Shen Kevin Wong Chuing, Shibraumalisi Nur Amirah, Yunus Asmil Yuzairi
Department of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
Primary Care Medicine Department, Faculty of Medicine, UiTM, Selayang Campus, 68100 Batu Caves, Selangor Darul Ehsan , Malaysia.
Bull Emerg Trauma. 2020 Oct;8(4):249-252. doi: 10.30476/beat.2020.85719.
Pancreatic injury in paediatrics is a rare condition and can be difficult to diagnose. The diagnostic challenge is due to its symptom of vague abdominal pain which usually results in late presentation. Elevated biochemical markers such as amylase and lipase can aid in the evaluation of pancreatic injury, however, it is not specific and is only evident after several hours of trauma. Ultrasound is commonly used as a primary modality to evaluate abdominal organ injuries, but its role in detecting pancreatic injury is limited due to low sensitivity. High index of suspicion is needed to avoid undiagnosed pancreatic injury which could be lethal to children. We herein report a case of delayed presentation of isolated pancreatic tail injury in a child who was sufficiently diagnosed with ultrasound and treated conservatively. Proper initial assessment and diagnosis will allow appropriate management of pancreatic injury. Conservative management should include serial imaging to look at the evolution of pancreatic injury and detect complications such as pseudocyst or abscess formation.
小儿胰腺损伤是一种罕见疾病，诊断困难。诊断难题在于其症状为腹痛模糊，这通常导致就诊延迟。淀粉酶和脂肪酶等生化标志物升高有助于评估胰腺损伤，然而，其不具有特异性，且仅在创伤数小时后才会显现。超声通常作为评估腹部器官损伤的主要手段，但由于敏感性低，其在检测胰腺损伤方面的作用有限。需要高度怀疑指数以避免漏诊胰腺损伤，这对儿童可能是致命的。我们在此报告一例儿童孤立性胰尾损伤延迟就诊的病例，该患儿通过超声得到充分诊断并接受了保守治疗。恰当的初始评估和诊断将有助于对胰腺损伤进行适当管理。保守治疗应包括系列影像学检查，以观察胰腺损伤的演变并检测诸如假性囊肿或脓肿形成等并发症。
