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pediatric pancreatic trauma

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https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#1
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28814248/pediatric-abdominal-trauma
#2
Tim Lynch
Abdominal trauma is present in approximately 25% of pediatric patients with major trauma and is the most common cause of unrecognized fatal injury in children. Pediatric abdominal trauma is typically blunt in nature with the spleen being the most common organ injured. Non-operative management is employed in over 95% of patients. Penetrating injuries are less common but often require operative management. Knowledge of specific mechanisms of injury aids the clinician in the diagnosis of specific injuries. Computed tomography (CT) is the gold standard in the identification of intra-abdominal injury...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#3
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28239409/iroa-international-register-of-open-abdomen-preliminary-results
#4
Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Paola Fugazzola, Davide Corbella, Francesco Salvetti, Ionut Negoi, Monica Zese, Savino Occhionorelli, Stefano Maccatrozzo, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Yovcho Yovtchev, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael L Curado, Gustavo Pereira Fraga, Bruno M Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Luca Ansaloni
BACKGROUND: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). METHODS: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. RESULTS: Four hundred two patients enrolled...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28139109/-distal-pancreatectomy-with-splenic-preservation-in-pediatric-patient-with-blunt-abdominal-trauma
#5
J T Palacios-Zertuche, J G Martínez-Flores, Q Gilte-Limas, M A Pinzón-Uresti, F J Reyna-Sepúlveda, G E Muñoz-Maldonado
INTRODUCTION: Traumatic injuries of the pancreas occur in 3 to 12% of cases of blunt abdominal trauma in children and these are associated with a mortality of 30%. CASE REPORT: A four-year-old girl was brought to the emergency room after an automobile accident. On physical examination, she was stable with abdominal pain and signs of peritoneal irritation. An abdominal CT scan showed a grade II liver lesion, a grade II splenic lesion, and a grade III pancreatic lesion...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28130170/identifying-children-at-very-low-risk-for-blunt-intra-abdominal-injury-in-whom-ct-of-the-abdomen-can-be-avoided-safely
#6
Christian J Streck, Adam M Vogel, Jingwen Zhang, Eunice Y Huang, Matthew T Santore, Kuojen Tsao, Richard A Falcone, Melvin S Dassinger, Robert T Russell, Martin L Blakely
BACKGROUND: Computed tomography is commonly used to rule out intra-abdominal injury (IAI) in children, despite associated cost and radiation exposure. Our purpose was to derive a prediction rule to identify children at very low risk for IAI after blunt abdominal trauma (BAT) for whom a CT scan of the abdomen would be unnecessary. STUDY DESIGN: We prospectively enrolled children younger than 16 years of age who presented after BAT at 14 Level I pediatric trauma centers during 1 year...
April 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28099382/failure-of-nonoperative-management-of-pediatric-blunt-liver-and-spleen-injuries-a-prospective-arizona-texas-oklahoma-memphis-arkansas-consortium-study
#7
Maria E Linnaus, Crystal S Langlais, Nilda M Garcia, Adam C Alder, James W Eubanks, R Todd Maxson, Robert W Letton, Todd A Ponsky, Shawn D St Peter, Charles Leys, Amina Bhatia, Daniel J Ostlie, David W Tuggle, Karla A Lawson, Alexander R Raines, David M Notrica
BACKGROUND: Nonoperative management (NOM) is standard of care for most pediatric blunt liver and spleen injuries (BLSI); only 5% of patients fail NOM in retrospective reports. No prospective studies examine failure of NOM of BLSI in children. The aim of this study was to determine the frequency and clinical characteristics of failure of NOM in pediatric BLSI patients. METHODS: A prospective observational study was conducted on patients 18 years or younger presenting to any of 10 Level I pediatric trauma centers April 2013 and January 2016 with BLSI on computed tomography...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27878593/re-evaluation-of-liver-transaminase-cutoff-for-ct-after-pediatric-blunt-abdominal-trauma
#8
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...
March 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27577183/management-of-blunt-pancreatic-trauma-in-children-review-of-the-national-trauma-data-bank
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
COMPARATIVE STUDY
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
#20
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
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