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pediatric pancreatic trauma

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https://www.readbyqxmd.com/read/27878593/re-evaluation-of-liver-transaminase-cutoff-for-ct-after-pediatric-blunt-abdominal-trauma
#1
Jessica A Zagory, Avafia Dossa, Jamie Golden, Aaron R Jensen, Catherine J Goodhue, Jeffrey S Upperman, Christopher P Gayer
PURPOSE: Current guidelines for computed tomography (CT) after blunt trauma were developed to capture all intra-abdominal injuries (IAI). We hypothesize that current AST/ALT guidelines are too low leading to unnecessary CT scans for children after blunt abdominal trauma (BAT). METHODS: Patients who received CT of the abdomen after blunt trauma at our Level I Pediatric Trauma Center were stratified into a high risk (HR) (liver/spleen/kidney grade ≥III, hollow viscous, or pancreatic injuries) and low risk (LR) (liver/kidney/spleen injuries grade ≤II, or no IAI) groups...
November 23, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27577183/management-of-blunt-pancreatic-trauma-in-children-review-of-the-national-trauma-data-bank
#2
Brian R Englum, Brian C Gulack, Henry E Rice, John E Scarborough, Obinna O Adibe
PURPOSE: This study aims to examine the current management strategies and outcomes after blunt pancreatic trauma in children using a national patient registry. METHODS: Using the National Trauma Data Bank (NTDB) from 2007-2011, we identified all patients ≤18years old who suffered blunt pancreatic trauma. Patients were categorized as undergoing nonoperative pancreatic management (no abdominal operation, abdominal operation without pancreatic-specific procedure, or pancreatic drainage alone) or operative pancreatic management (pancreatic resection/repair)...
September 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27535145/incidence-and-clinical-associations-of-childhood-acute-pancreatitis
#3
Abdalmonem A Majbar, Eleri Cusick, Paul Johnson, Richard M Lynn, Linda P Hunt, Julian P H Shield
OBJECTIVES: To establish the UK incidence and clinical associations of acute pancreatitis (AP) in children aged 0 to 14 years. METHODS: Monthly surveillance of new cases of AP in children under 15 years of age through the British Pediatric Surveillance Unit conducted from April 2013 to April 2014 (inclusive) followed by 1-year administrative follow-up for all valid cases. RESULTS: Ninety-four cases (48 boys) fulfilled the diagnostic criteria...
September 2016: Pediatrics
https://www.readbyqxmd.com/read/27376827/practice-variability-exists-in-the-management-of-high-grade-pediatric-pancreatic-trauma
#4
Bindi Naik-Mathuria
PURPOSE: Management of high-grade pancreatic trauma in children is controversial, although recent evidence supports early operation. We sought to evaluate whether practice variability exists regarding the management of these rare and complex injuries. METHODS: A study group of pediatric trauma centers within the Pediatric Trauma Society completed a survey following a query of their institutional database. Results are presented using descriptive statistics. RESULTS: Over a 3-year period (2012-2014), 123 pancreatic injuries (grades II-IV) were reported from 19 pediatric trauma centers (median 6, range 1-22)...
August 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27258506/posterior-reversible-encephalopathy-syndrome-complicating-traumatic-pancreatitis-a-pediatric-case-report
#5
Anna Sigurtà, Valeria Terzi, Caroline Regna-Gladin, Roberto Fumagalli
We are reporting a case of posterior reversible encephalopathy syndrome (PRES) developed in an unusual clinical scenario without the presence of the most described symptoms. PRES is a neurological and radiological syndrome described in many different clinical conditions. In children it has been mostly reported in association with hematological and renal disorders.Our patient was a 15 years old boy, admitted to our intensive care unit for pancreatitis after blunt abdominal trauma.During the stay in the intensive care unit, he underwent multiple abdominal surgical interventions for pancreatitis complications...
May 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27075018/diagnostic-imaging-of-blunt-abdominal-trauma-in-pediatric-patients
#6
REVIEW
Vittorio Miele, Claudia Lucia Piccolo, Margherita Trinci, Michele Galluzzo, Stefania Ianniello, Luca Brunese
Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements...
May 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/26964550/role-of-computed-tomography-in-pediatric-abdominal-conditions
#7
REVIEW
Anu Eapen, Sridhar Gibikote
In the pediatric patient, computed tomography (CT) scan as an imaging modality for evaluation of the abdomen is to be used judiciously. The use of correct scanning protocols, single phase scanning, scanning only when required are key factors to minimize radiation doses to the child, while providing diagnostic quality. CT is the preferred modality in the evaluation of trauma, to assess extent of solid organ or bowel injury. It is also useful in several inflammatory conditions such as inflammatory bowel diseases and acute pancreatitis...
July 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/26958678/-etiology-of-acute-pancreatitis-underestimated-problem-in-pediatrics
#8
REVIEW
Tatiana Jamer
Pediatric pancreatitis has received much attention during the past few years. The incidence of acute pancreatitis in children has increased over the past 20 years. Therefore, acute pancreatitis should be considered during the differential diagnosis of abdominal pain in children. The etiological factors are different than in adults and, in recent reports, a wide range of potential causes has been associated with acute pancreatitis in children. The most common etiology of acute pancreatitis in children are biliary duct disorders, drugs, systemic diseases, trauma and also genetic factors...
July 2015: Developmental Period Medicine
https://www.readbyqxmd.com/read/26933627/the-safety-and-efficacy-of-ercp-in-the-pediatric-population-with-standard-scopes-does-size-really-matter
#9
Abdullah Emre Yıldırım, Reskan Altun, Serkan Ocal, Murat Kormaz, Figen Ozcay, Haldun Selcuk
Experience with endoscopic retrograde cholangiopancreatography in the pediatric population is limited. The aim of this study was to evaluate the outcomes of ERCP in the pediatric population performed by adult gastroenterologists with standard duodenoscopes. This study is a structured retrospective review of endoscopic reports, computerized and paper medical records, and radiographic images of patients under the age of 18 who underwent ERCP for any indication at a tertiary referral centre. Data regarding demographic characteristics and medical history of patients, indications, technical success rate, final clinical diagnosis, and complications were analyzed...
2016: SpringerPlus
https://www.readbyqxmd.com/read/26857478/predicting-pseudocyst-formation-following-pancreatic-trauma-in-pediatric-patients
#10
Bahattin Aydogdu, Serkan Arslan, Hikmet Zeytun, Mehmet Serif Arslan, Erol Basuguy, Mustafa İçer, Cemil Goya, Mehmet Hanifi Okur, Ibrahim Uygun, Murat Kemal Cıgdem, Abdurrahman Onen, Selcuk Otcu
BACKGROUND: There are insufficient data on pre-screening for pancreatic pseudocysts (PC) following pancreatic trauma. This study investigated the use of radiological and laboratory testing for predicting the development of pancreatic pseudocysts after trauma. MATERIALS AND METHODS: The clinical records of all pediatric patients presenting with pancreatic trauma between January 2003 and December 2014 were reviewed retrospectively. Patients with American Association for the Surgery of Trauma (AAST) scores of Grade 3-5 were enrolled...
June 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/26850907/pediatric-abdominal-injury-patterns-caused-by-falls-a-comparison-between-nonaccidental-and-accidental-trauma
#11
Kyle W Carter, Steven L Moulton
BACKGROUND/PURPOSE: Falling from a low height is the most common history given by caregivers of pediatric nonaccidental trauma (NAT) victims evaluated for blunt abdominal trauma (BAT). The purpose of this study is to compare the patterns of injuries seen in children with BAT who are victims of NAT with those seen after a fall-related incident. METHODS: Trauma database query from regional pediatric trauma centers identified patients were who were evaluated for BAT resulting from either NAT or a fall...
February 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26776354/operative-vs-nonoperative-management-of-pediatric-blunt-pancreatic-trauma-evaluation-of%C3%A2-the-national-trauma-data-bank
#12
Maria Carmen Mora, Kaitlyn E Wong, Jennifer Friderici, Katharine Bittner, Kevin P Moriarty, Lisa A Patterson, Ronald I Gross, Michael V Tirabassi, David B Tashjian
BACKGROUND: Traumatic pancreatic injury is associated with significant morbidity and mortality. We evaluated the differences in outcomes among children with blunt pancreatic injuries managed operatively and nonoperatively. STUDY DESIGN: The National Trauma Data Bank was evaluated from 2002 to 2011. Patients less than18 years of age with blunt pancreatic injuries and Abbreviated Injury Scale (AIS) scores ≥ 3 were identified. Patients were divided into nonoperative (NO), operative (O), and delayed operative (DO; operation performed 48 hours or more after admission) groups...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26418761/pediatric-blunt-abdominal-trauma-current-management
#13
REVIEW
David M Notrica
PURPOSE OF REVIEW: Nonoperative management of pediatric blunt abdominal injury has changed significantly in the last few years. RECENT FINDINGS: Improved resource utilization in the diagnosis of pediatric abdominal injury has been described. Hemodynamic status, rather than grade of injury, now guides care. Stable patients spend less time in the hospital, return to school upon discharge, and are allowed lower hemoglobin levels prior to transfusion. ICUs are reserved for those with recent or ongoing bleeding, previously unstable patients, or children with concomitant injuries necessitating ICU...
December 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26302354/comparison-of-clinician-suspicion-versus-a-clinical-prediction-rule-in-identifying-children-at-risk-for-intra-abdominal-injuries-after-blunt-torso-trauma
#14
MULTICENTER STUDY
Prashant Mahajan, Nathan Kuppermann, Michael Tunik, Kenneth Yen, Shireen M Atabaki, Lois K Lee, Angela M Ellison, Bema K Bonsu, Cody S Olsen, Larry Cook, Maria Y Kwok, Kathleen Lillis, James F Holmes
OBJECTIVES: Emergency department (ED) identification and radiographic evaluation of children with intra-abdominal injuries who need acute intervention can be challenging. To date, it is unclear if a clinical prediction rule is superior to unstructured clinician judgment in identifying these children. The objective of this study was to compare the test characteristics of clinician suspicion with a derived clinical prediction rule to identify children at risk of intra-abdominal injuries undergoing acute intervention following blunt torso trauma...
September 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26200695/what-is-the-role-of-endoscopic-retrograde-cholangiopancreatography-in-assessing-traumatic-rupture-of-the-pancreatic-in-children
#15
Radan Keil, Jiri Drabek, Jindra Lochmannova, Jan Stovicek, Michal Rygl, Jiri Snajdauf, Stepan Hlava
BACKGROUND AND STUDY AIMS: Trauma is one of the most common causes of morbidity and mortality in the pediatric population. The diagnosis of pancreatic injury is based on clinical presentation, laboratory and imaging findings, and endoscopic methods. CT scanning is considered the gold standard for diagnosing pancreatic trauma in children. PATIENTS AND METHODS: This retrospective study evaluates data from 25 pediatric patients admitted to the University Hospital Motol, Prague, with blunt pancreatic trauma between January 1999 and June 2013...
2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/26157692/characteristics-of-pediatric-pancreatitis-on-magnetic-resonance-cholangiopancreatography
#16
REVIEW
Jae-Yeon Hwang, Hye-Kyung Yoon, Kyung Mo Kim
Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children. Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology. Magnetic resonance cholangiopancreatography (MRCP) is a good imaging modality for evaluating pancreatitis and determining etiology without exposure to radiation. This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP...
June 2015: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/26040998/possible-sulfamethoxazole-trimethoprim-induced-pancreatitis-in-a-complicated-adolescent-patient-posttraumatic-injury
#17
Susan E Dickey, William A Mabry, Leslie A Hamilton
INTRODUCTION: Multiple medications have been associated with pancreatitis, however, data in the pediatric population are scarce secondary to the nonspecific presentation and infrequent diagnosis. The aim of this report is to characterize drug-induced pancreatitis in an adolescent patient. CASE PRESENTATION: A 16-year-old African-American female presented with a surgical site infection 8 weeks after a motor vehicle accident with multiple traumas. Two weeks prior to the admission, the patient was hospitalized for a urinary tract infection (UTI) and was initiated on sulfamethoxazole/trimethoprim (TMP/SMX) daily for UTI prophylaxis...
August 2015: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/26038029/management-of-blunt-pancreatic-trauma-what-s-new
#18
REVIEW
D A Potoka, B A Gaines, A Leppäniemi, A B Peitzman
Pancreatic injuries are relatively uncommon but present a major challenge to the surgeon in terms of both diagnosis and management. Pancreatic injuries are associated with significant mortality, primarily due to associated injuries, and pancreas-specific morbidity, especially in cases of delayed diagnosis. Early diagnosis of pancreatic trauma is a key for optimal management, but remains a challenge even with more advanced imaging modalities. For both penetrating and blunt pancreatic injuries, the presence of main pancreatic ductal injury is the major determinant of morbidity and the major factor guiding management decisions...
June 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/25973660/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-pancreatitis-paediatrics-and-trauma
#19
REVIEW
Jan J De Waele, Janeth C Ejike, Ari Leppäniemi, Bart L De Keulenaer, Inneke De Laet, Andrew W Kirkpatrick, Derek J Roberts, Edward Kimball, Rao Ivatury, Manu L N G Malbrain
Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction among patients with trauma and sepsis. However, the impact of increased intra-abdominal pressure (IAP) among pediatric, pregnant, non-septic medical patients, and those with severe acute pancreatitis (SAP), obesity, and burns has been studied less extensively. The aim of this review is to outline the pathophysiologic implications and treatment options for IAH and abdominal compartment syndrome (ACS) for the above patient populations...
2015: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/25638632/role-of-ercp-in-pediatric-blunt-abdominal-trauma-a-case-series-at-a-level-one-pediatric-trauma-center
#20
Erin M Garvey, Danielle J Haakinson, Mark McOmber, David M Notrica
BACKGROUND: There is no consensus regarding the appropriate use of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric trauma. We report our experience with ERCP for management of pediatric pancreatic and biliary injury following blunt abdominal trauma. METHODS: A retrospective chart review was performed for pediatric patients with blunt abdominal trauma from July 2008 through December 2012 at our pediatric trauma center. For patients who underwent ERCP, demographics, injury characteristics, diagnostic details, procedures performed, length of stay, total parenteral nutrition use, and complications were reviewed...
February 2015: Journal of Pediatric Surgery
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