A CASE OF PEDIATRIC PANCREATIC HEAD TRAUMA ASSOCIATED WITH HEPATOSPLENIC INJURY TREATED CONSERVATIVELY WITH ASCITES DRAINAGE

Abstract

　　We describe the case of a 9-year-old girl who was in a motor vehicle accident. She was in shock on hospital arrival. Endovascular treatment was performed for intra-abdominal hemorrhage from hepatosplenic injury. Although pancreatic head injury was suspected on trauma pan scan, the patient demonstrated hemodynamic improvement ; therefore, conservative treatment was applied in the form of ascites drainage using a catheter. Hyper-amylase ascites was drained until day 9. After the start of meals on day 10, her serum amylase level increased. Cystic fluid collection around the pancreatic head was noted on magnetic resonance imaging on day 17. No worsening abdominal symptoms were noted ; therefore, she was discharged on day 24 and followed up in an outpatient setting. The pancreatic pseudocyst gradually shrank and spontaneously disappeared on day 52. Thus, conservative therapy with ascites drainage was suggested to be useful for pediatric pancreatic head trauma with suspected main pancreatic duct injury.