IJCM  Vol.7 No.12 , December 2016
Blunt Abdominal Trauma Leading to Pancreatic Injury in Childhood. Delay in Diagnosis Leads to Poor Outcomes—A Case Presentation
Abstract: This case report illustrates the difficulty in diagnosing paediatric patients with life threatening pancreatic injuries. A high index of suspicion is essential as late diagnosis significantly affects outcomes. A 9-year-old child presented with epigastric pain following an accident on his pushbike. The patient was examined in paediatric accident and emergency (A/E) and was discharged. He returned twice more to A/E and on the third visit, 5 days after the initial incident, a CT scan was performed. This showed a classical injury to the body of the pancreas with a collection in the lesser sac. The patient was transferred to the regional hepato-pancreato-biliary unit (HPB unit) and underwent surgery. Pancreatic injuries can be difficult to detect clinically and patients may be well on initial presentation with normal observations and routine bloods. Early CT scanning confirms the diagnosis and results in early specialist referral and better outcomes.
Cite this paper: Siddiqui, Z. , Husain, F. and Siddiqui, M. (2016) Blunt Abdominal Trauma Leading to Pancreatic Injury in Childhood. Delay in Diagnosis Leads to Poor Outcomes—A Case Presentation. International Journal of Clinical Medicine, 7, 809-813. doi: 10.4236/ijcm.2016.712087.

[1]   Sivit, C.J. (2009) Imaging Children with Abdominal Trauma. American Journal of Roentgenology, 192, 1179-1189.

[2]   Coleman, J.J. (2015) Blunt Abdominal Trauma. In: Common Surgical Diseases, Springer, New York, 49-50.

[3]   Arkovitz, M.S., Johnson, N. and Garcia, V.F. (1997) Pancreatic Trauma in Children: Mechanisms of Injury. Journal of Trauma and Acute Care Surgery, 42, 49-53.

[4]   Clarnette, T.D. and Beasley, S.W. (1997) Handlebar Injuries in Children: Patterns and Prevention. Australian and New Zealand Journal of Surgery, 67, 338-339.

[5]   Wegner, S., Colletti, J.E. and Van Wie, D. (2006) Pediatric Blunt Abdominal Trauma. Pediatric Clinics of North America, 53, 243-256.

[6]   Sivit, C.J., Eichelberger, M.R., Taylor, G.A., Bulas, D.I., Gotschall, C.S. and Kushner, D.C. (1992) Blunt Pancreatic Trauma in Children: CT Diagnosis. American Journal of Roentgenology, 158, 1097-1100.

[7]   Rekhi, S., Anderson, S.W., Rhea, J.T. and Soto, J.A. (2010) Imaging of Blunt Pancreatic Trauma. Emergency Radiology, 17, 13-19.

[8]   Venkatesh, S.K. and Wan, J.M. (2008) CT of Blunt Pancreatic Trauma—A Pictorial Essay. European Journal of Radiology, 67, 311-320.

[9]   Adamson, W.T., Hebra, A., Thomas, P.B., Wagstaff, P., Tagge, E.P. and Othersen, H.B. (2003) Serum Amylase and Lipase Alone Are Not Cost-Effective Screening Methods for Pediatric Pancreatic Trauma. Journal of Pediatric Surgery, 38, 354-357.

[10]   Bosboom, D., Braam, A.W., Blickman, J.G. and Wijnen, R.M. (2006) The Role of Imaging Studies in Pancreatic Injury Due to Blunt Abdominal Trauma in Children. European Journal of Radiology, 59, 3-7.