Management and outcomes of peripancreatic fluid collections and pseudocysts following non-operative management of pancreatic injuries in children

Rosenfeld, Eric H.; Vogel, Adam M.; Jafri, Mubeen; Burd, Randall S.; Russell, Robert T.; Beaudin, Marianne; Sandler, Alexis B.; Thakkar, Rajan K.; Falcone, Richard A.; Wills, Hale; Upperman, Jeffrey S.; Burke, Rita V.; Escobar, Mauricio A.; Klinkner, Denise B.; Gaines, Barbara A.; Gosain, Ankush; Campbell, Brendan T.; Mooney, David P.; Stallion, Anthony; Fenton, Stephon J.; Prince, José M.; Juang, David; Kreykes, Nathaniel S.; Naik‐Mathuria, Bindi

doi:10.1007/s00383-019-04492-3

Cited by 18 publications

(19 citation statements)

References 24 publications

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“…It has been pointed out in the literature that early clarification of the classification of pancreatic injury and whether the pancreatic duct and cyst are connected plays a crucial role in the selection of treatment methods. For PCC caused by trauma, external drainage is preferred; for PCC caused by pancreatitis, internal drainage should be advocated ( 10 , 11 ). Endoscopic ultrasound-guided pseudocyst puncture and drainage have gradually become the first-line treatment for PPC due to its advantages of less trauma, fewer complications, short hospital stay, and low cost ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Massive gastrointestinal haemorrhage caused by pancreatic pseudocyst complicated with Dieulafoy's disease in a child: A case report and review of the literature

et al. 2022

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BackgroundPancreatic pseudocyst (PPC) with massive gastrointestinal bleeding is rare, especially in children. Inadvertent intraoperative examination and damage to the gastric mucosa and malformed blood vessels by the fluid content of PPC can lead to massive bleeding, which may endanger the patient's life.Case presentationHere, we present a case of an 8-year-old boy who was diagnosed with a massive gastrointestinal haemorrhage caused by PPC complicated with Dieulafoy's disease. At his first admission, his complaint was being hit to the stomach by the handlebar while riding bicycle 24 h before admission. After being hospitalized, he was diagnosed with pancreatic injury by abdominal CT. Conservative treatment lasted for 1 month in the Department of Pediatric Surgery. Then, a pancreatic pseudocyst was formed. Under the guidance of ultrasonic endoscopy, cyst puncture and drainage of pseudocysts through the gastric wall were performed. Unexplained hematemesis occurred 8 days after surgery. Emergency gastroscopy was performed, and abnormal submucosal vascular haemorrhage was found at the gastric fundus. Gastric Dieulafoy's disease was diagnosed. The boy underwent gastroscopic titanium clipping of abnormal arteries. He had no complications during the 3-month follow-up. Then, the patient returned to the hospital, and the stent was removed under endoscopy. No bleeding was found, and the patient was discharged. The patient recovered smoothly and was followed up for half a year without any complications, and hematological indicators were normal.ConclusionEndoscopic ultrasonography-guided gastric puncture and internal drainage of cysts is a safe and effective surgical method for the treatment of pancreatic pseudocysts. However, at the same time, it is necessary to thoroughly and carefully explore the stomach cavity to prevent adverse consequences caused by a missed diagnosis of gastric Dieulafoy's disease or other abnormal abnormalities.

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Section: Discussionmentioning

confidence: 99%

Massive gastrointestinal haemorrhage caused by pancreatic pseudocyst complicated with Dieulafoy's disease in a child: A case report and review of the literature

et al. 2022

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“…Pancreatic fluid collections are common following pancreatic trauma, especially when non-operative management is used; however, not all will develop into a pseudocyst. [2][3][4][5] The revised Atlanta classification defines a pseudocyst as a collection present 4 weeks or more postinjury. 6 Approximately 15%-18% of patients managed non-operatively will develop pseudocysts and approximately 10%-33% of pseudocysts will require subsequent drainage.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic cyst gastrostomy for traumatic pancreatic pseudocysts in children: a case series

Farr

Fox

Mooney

2020

Trauma Surg Acute Care Open

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BackgroundPancreatic pseudocysts may develop after high-grade pancreatic injuries in children. Many resolve without intervention, and the management of symptomatic pseudocysts that persist remains controversial, with various open, percutaneous and laparoscopic approaches to intervention described. Successful endoscopic cyst gastrostomy has been reported in children with pancreatic pseudocysts of mixed etiology.MethodsThe trauma registry and electronic medical record of a level 1 pediatric trauma center were queried for children with a symptomatic pseudocyst following pancreatic trauma over a 12-year period, from 2008 to 2019.ResultsWe describe a case series of five consecutive children with persistent symptomatic pancreatic pseudocysts following blunt abdominal trauma all successfully treated with endoscopic cyst gastrostomy.DiscussionEndoscopic cyst gastrostomy appears to be safe and effective in the management of symptomatic pancreatic pseudocysts in children following pancreatic trauma.Level of evidence5 – retrospective case series.

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“…Non-operative management of pancreatic injuries in children is not without risk. In a series of 100 pediatric patients with pancreatic injury, 42% developed organized fluid collections, over half of which ultimately required intervention (3). Another review of operative versus nonoperative management of pancreatic injury in children demonstrated a significantly higher proportion of patients with pseudocyst formation in those with the non-operative approach (4).…”

Section: Traumatic Pancreatic Injurymentioning

confidence: 99%

Minimally invasive surgery of the pancreas: a narrative review of current practice

Richards¹,

Clifton²

2021

Transl Gastroenterol Hepatol

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BackgroundMinimally invasive surgery for children with pancreatic pathology is a topic that is covered sporadically in the literature, with most information limited to case reports or case series. Newer trials evaluating strategies for management aim to capture the relatively small volume of patients with these issues by capitalizing on multiinstitutional data sets. The information may be organized by specific pathology or by the type of operation used to ameliorate the problem. Herein we limit the discussion to the pathology most amenable to laparoscopy: distal pancreatectomy, subtotal pancreatectomy, enucleation and lateral pancreatojejunostomy. The intent of this manuscript is to give the reader an overview of the newest information available for a minimally invasive approach to the pancreas. We present the following article in accordance with the Narrative Review reporting checklist (available at http:// dx.

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Management and outcomes of peripancreatic fluid collections and pseudocysts following non-operative management of pancreatic injuries in children

Cited by 18 publications

References 24 publications

Massive gastrointestinal haemorrhage caused by pancreatic pseudocyst complicated with Dieulafoy's disease in a child: A case report and review of the literature

Massive gastrointestinal haemorrhage caused by pancreatic pseudocyst complicated with Dieulafoy's disease in a child: A case report and review of the literature

Endoscopic cyst gastrostomy for traumatic pancreatic pseudocysts in children: a case series

Minimally invasive surgery of the pancreas: a narrative review of current practice

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