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Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank.

Publication ,  Journal Article
Englum, BR; Gulack, BC; Rice, HE; Scarborough, JE; Adibe, OO
Published in: J Pediatr Surg
September 2016

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). Patient characteristics, operative details, clinical outcomes, and factors associated with operative management were examined. RESULTS: Of 610,402 pediatric cases in the NTDB, 1653 children (0.3%) had blunt pancreatic injury and 674 had information on specific location of pancreatic injury. Of these 674 cases, 514 (76.3%) underwent nonoperative pancreatic management. The groups were similar in age, gender, and race; however, pancreatic injury grade>3, moderate to severe injury severity, and bicycle accidents were associated with operative management in multivariable analysis. Children with pancreatic head injuries or GCS motor score<6 were less likely to undergo pancreatic operation. Overall morbidity and mortality rates were 26.5% and 5.3%, respectively. Most outcomes were similar between treatment groups, including mortality (2.5% vs. 6.7% in operative vs. nonoperative cohorts respectively; p=0.07). CONCLUSION: Although rare, blunt pancreatic trauma in children continues to be a morbid injury. In the largest analysis of blunt pancreatic trauma in children, we provide data on which to base future prospective studies. Operative management of pancreatic trauma occurs most often in children with distal ductal injuries, suggesting that prospective studies may want to focus on this group.

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Published In

J Pediatr Surg

DOI

EISSN

1531-5037

Publication Date

September 2016

Volume

51

Issue

9

Start / End Page

1526 / 1531

Location

United States

Related Subject Headings

  • Wounds, Nonpenetrating
  • United States
  • Treatment Outcome
  • Practice Patterns, Physicians'
  • Pediatrics
  • Pancreatectomy
  • Pancreas
  • Male
  • Infant, Newborn
  • Infant
 

Citation

APA
Chicago
ICMJE
MLA
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Englum, B. R., Gulack, B. C., Rice, H. E., Scarborough, J. E., & Adibe, O. O. (2016). Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank. J Pediatr Surg, 51(9), 1526–1531. https://doi.org/10.1016/j.jpedsurg.2016.05.003
Englum, Brian R., Brian C. Gulack, Henry E. Rice, John E. Scarborough, and Obinna O. Adibe. “Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank.J Pediatr Surg 51, no. 9 (September 2016): 1526–31. https://doi.org/10.1016/j.jpedsurg.2016.05.003.
Englum BR, Gulack BC, Rice HE, Scarborough JE, Adibe OO. Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank. J Pediatr Surg. 2016 Sep;51(9):1526–31.
Englum, Brian R., et al. “Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank.J Pediatr Surg, vol. 51, no. 9, Sept. 2016, pp. 1526–31. Pubmed, doi:10.1016/j.jpedsurg.2016.05.003.
Englum BR, Gulack BC, Rice HE, Scarborough JE, Adibe OO. Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank. J Pediatr Surg. 2016 Sep;51(9):1526–1531.
Journal cover image

Published In

J Pediatr Surg

DOI

EISSN

1531-5037

Publication Date

September 2016

Volume

51

Issue

9

Start / End Page

1526 / 1531

Location

United States

Related Subject Headings

  • Wounds, Nonpenetrating
  • United States
  • Treatment Outcome
  • Practice Patterns, Physicians'
  • Pediatrics
  • Pancreatectomy
  • Pancreas
  • Male
  • Infant, Newborn
  • Infant