Abstract
Main pancreatic duct injury is rare in children and its therapeutic strategy is still controversial. Here, we report the case of a 6-year-old boy treated by only open drainage without distal pancreatectomy. He presented with abdominal pain after blunt abdominal trauma caused by a handlebar of a bicycle. An imaging study revealed main pancreatic duct injury with a giant pseudocyst, and he was transferred to our hospital 11 days after the onset of the injury. Endoscopic retrograde pancreatography (ERP) was performed, and cannulation into the pseudocyst was unsuccessful. On the day after ERP, he presented with acute abdominal pain with the rupture of the pseudocyst, requiring open drainage. His postoperative course was satisfactory and he was discharged 75 days after the onset with atrophy of the distal pancreas. Conservative management of pancreatic duct injury in children with or without drainage is associated with an extended hospital stay duration and the prolonged need for TPN. Operative management with pancreatic surgery could shorten the hospital stay but with the risk of surgical complications. Therefore, the choice of therapeutic strategy should depend on the patient’s condition.
