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一名七岁女孩钝性创伤后孤立性胰腺损伤:病例报告

Isolated pancreatic injury following blunt trauma in a seven-year-old girl: A case report.

作者信息

Bhatta Om Prakash, Bhetwal Prashant, Gyawali Prakash, Yadav Krishna, Devkota Shritik, Koirala Dinesh Prasad

机构信息

Department of Emergency Medicine, Nova Hospital, Kailali, Nepal.

Panchkhal Primary Health Care Centre, Kavrepalanchowk, Nepal.

出版信息

Int J Surg Case Rep. 2024 Feb;115:109280. doi: 10.1016/j.ijscr.2024.109280. Epub 2024 Jan 20.

Abstract

INTRODUCTION AND IMPORTANCE

Isolated pancreatic injury following blunt abdominal trauma is rare, and the absence of definite clinical signs and symptoms may delay diagnosis and management.

CASE PRESENTATION

We present the case of a seven-year-old girl with a history of progressive, periumbilical abdominal pain and multiple episodes of non-bilious, non-blood mixed vomiting following a road traffic accident. Computed tomography (CT) imaging revealed an isolated grade three pancreatic injury managed conservatively.

CLINICAL DISCUSSION

The patient usually presents with epigastric tenderness with or without a rise in pancreatic enzyme levels. CT grading of injury correlates with and guides the management approach, and CT abdomen with contrast is the preferred investigation for diagnosis. Management depends on the grade of injury, the hemodynamic status of the children, and the co-existence of other injuries.

CONCLUSION

Isolated pancreatic injury, although rare, can go undiagnosed due to a lack of suspicion from the treating surgeon and may have dire consequences. Conservative management can be a suitable strategy for children with stable hemodynamic status.

摘要

引言与重要性

钝性腹部创伤后孤立性胰腺损伤罕见,且缺乏明确的临床体征和症状可能会延误诊断和治疗。

病例介绍

我们报告一例七岁女童病例,其在道路交通事故后出现进行性脐周腹痛和多次非胆汁性、非血性混合呕吐。计算机断层扫描(CT)成像显示为孤立性三级胰腺损伤,采取保守治疗。

临床讨论

患者通常表现为上腹部压痛,胰腺酶水平可有或无升高。损伤的CT分级与治疗方法相关并指导治疗方法,腹部增强CT是诊断的首选检查。治疗取决于损伤的分级、儿童的血流动力学状态以及其他损伤的并存情况。

结论

孤立性胰腺损伤虽然罕见,但由于主治外科医生缺乏怀疑可能未被诊断,可能会产生严重后果。对于血流动力学稳定的儿童,保守治疗可能是一种合适的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16a/10844805/dbea9df585be/gr1.jpg

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