Nauka Przyroda Technologie

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2017 volume 11 issue 4, 415-425 http://dx.doi.org/10.17306/J.NPT.00216
Jakub Noskiewicz, Paweł Juszczak, Michał Sawicki, Olgierd Pietkiewicz, Sebastian Moryciński, Przemysław Mańkowski
Pancreatic trauma in children
Summary.

Background. The pancreas is an important organ responsible for metabolism, regulation of the glucose level and digestion. Pancreatic traumas are more common in children than in adults. Blunt traumatic injuries of the pancreas are the fourth most common organ injuries. Diagnosis and treatment of patients with pancreatic traumas remains a significant problem in paediatric trau­matology.

Material and methods. The researchers made a retrospective analysis of patients with blunt pancreatic trauma treated at the Department of Paediatric Surgery, Traumatology and Urology, Poznań University of Medical Sciences, Poland. Diagnostic and therapeutic procedures (operative or non-operative treatment) were evaluated. The data obtained in the analysis were compared and evaluated using the methods and tools of descriptive statistics.

Results. Pancreatic trauma occurred mainly in children aged 7–11 years (73%). The most frequent mechanism causing an injury was a bump by the bicycle handlebar (47%). Other causes of pancreatic injury include: traffic accidents (20%), blunt abdominal trauma (20%) and crushing (13%). 66% of the patients were classified as grade I in the AAST pancreas injury scale. All the patients underwent abdominal ultrasonography and levels of pancreatic enzymes were measured, which allowed recognition of all pancreatic injuries (100% sensitivity). Haemodynamically stable patients were treated conservatively (73%) using nutritional therapy and antibiotics (carbapenems). Total parenteral nutrition was applied to 40% of the patients. The children whose pancreatic tissue was completely severed or whose duct of Wirsung was damaged underwent surgical treatment (usually pancreatojejunostomy). Two patients developed pseudocysts, which were successfully treated by external drainage.

Conclusions. Therapy should be individually adjusted to the patient’s general condition, the extent of pancreatic injury, comorbidity and the availability of diagnostic and therapeutic methods. Conservative treatment is recommended to haemodynamically stable children.

Key words: pancreas, trauma, child, nutritional therapy
PDFFull text available in Polish in Adobe Acrobat format:
http://www.npt.up-poznan.net/tom11/zeszyt4/art_39.pdf

http://dx.doi.org/10.17306/J.NPT.00216

For citation:

MLA Noskiewicz, Jakub, et al. "Urazy trzustki u dzieci." Nauka Przyr. Technol. 11.4 (2017): 415-425. http://dx.doi.org/10.17306/J.NPT.00216
APA Jakub Noskiewicz1, Paweł Juszczak1;2, Michał Sawicki1, Olgierd Pietkiewicz1, Sebastian Moryciński1, Przemysław Mańkowski1 (2017). Urazy trzustki u dzieci. Nauka Przyr. Technol. 11 (4), 415-425 http://dx.doi.org/10.17306/J.NPT.00216
ISO 690 NOSKIEWICZ, Jakub, et al. Urazy trzustki u dzieci. Nauka Przyr. Technol., 2017, 11.4: 415-425. http://dx.doi.org/10.17306/J.NPT.00216
Corresponding address:
Jakub Noskiewicz
Katedra i Klinika Chirurgii
Traumatologii i Urologii Dziecięcej
Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
ul. Szpitalna 27/33
60-572 Poznań
Poland
e-mail: jnoskiewicz@op.pl
Accepted for print: 30.11.-0001