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小儿创伤后胰腺炎的导管相关并发症:来自叙利亚的一例病例报告。

Duct-related complications of pediatric post-traumatic pancreatitis: A case report from Syria.

作者信息

Kheir Farah Abou, Moustafa Leen, Ahmad Loujain, Kamil Hazem, Mahmod Jaber, Sandouk Fayez

机构信息

Damascus University, Faculty of Medicine, Damascus, Syrian Arab Republic.

Damascus University, Faculty of Medicine, Damascus, Syrian Arab Republic.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110885. doi: 10.1016/j.ijscr.2025.110885. Epub 2025 Jan 13.

Abstract

INTRODUCTION

Pancreatic trauma is a rare type of abdominal injury, representing only 0.3 % of pediatric trauma cases. This condition may progress to chronic pancreatitis and result in multiple complications following damage to the pancreatic duct.

PRESENTATION OF CASE

A 5-year-old boy presented to the hospital with abdominal pain and had a history of chronic pancreatitis following a bicycle handlebar accident one year ago. Ultrasound screening revealed the presence of abdominal ascites which was treated conservatively. Two months post-treatment, the patient developed a pseudocyst in the head of the pancreas and a right-sided pleural effusion that was treated by inserting a plastic stent into the pancreatic duct through endoscopic retrograde cholangiopancreatography (ERCP). This caused inflammation of the pseudocyst, which was eventually drained to the stomach using endoscopy. No recurrence was observed after removing the stents four weeks later.

DISCUSSION

Invasive techniques like ERCP are necessary for some cases of pancreatic fistulas that do not respond well to conservative treatment.

CONCLUSION

ERCP is an effective way to diagnose and treat several duct-related complications of traumatic pancreatitis. Although ideal management of such rare conditions remains highly debatable, non-invasive strategies are preferable for pediatric patients.

摘要

引言

胰腺创伤是一种罕见的腹部损伤类型,仅占小儿创伤病例的0.3%。这种情况可能会发展为慢性胰腺炎,并在胰管受损后导致多种并发症。

病例介绍

一名5岁男孩因腹痛入院,有一年前自行车车把事故后慢性胰腺炎的病史。超声检查发现有腹腔积液,进行了保守治疗。治疗两个月后,患者胰腺头部出现假性囊肿和右侧胸腔积液,通过内镜逆行胰胆管造影术(ERCP)将塑料支架插入胰管进行治疗。这导致假性囊肿发炎,最终通过内镜引流至胃内。四周后取出支架,未观察到复发。

讨论

对于一些对保守治疗反应不佳的胰腺瘘病例,像ERCP这样的侵入性技术是必要的。

结论

ERCP是诊断和治疗创伤性胰腺炎几种与导管相关并发症的有效方法。尽管对于这种罕见病症的理想治疗方法仍存在很大争议,但对于儿科患者,非侵入性策略更为可取。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec1e/11782821/6fff37fd5cb7/gr1.jpg

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