Traumatic pancreatitis: Long-term review of initial non-operative management in children

Objective: To assess the safety and long‐term efficacy of an initial non‐operative approach to the management of pancreatic trauma in children. Methodology: Retrospective case‐note review of children admitted to our institution with the diagnosis of pancreatic trauma over a 10‐year period from 1985 to 1994 inclusive. Results: Fourteen children were identified with a diagnosis of traumatic pancreatitis. Eleven of the injuries were secondary to motor vehicle accidents or trauma from a bicycle handlebar. In seven patients there were associated intra‐abdominal injuries and in eight patients the traumatic pancreatitis was complicated by development of a pseudocyst. Three pseudocysts settled without intervention, two resolved with percutaneous external drainage and the remaining three required open surgery. The mean in‐patient stay was 21.2 days. The average length of follow‐up was 7.7 years with no observed long‐term complications. Conclusions: Non‐operative management of traumatic pancreatitis in the absence of complete duct transection is safe in children and does not appear to be associated with adverse sequelae.