Abstract
Type IIIb pancreatic injury is extremely rare in children and its therapeutic strategy is still controversial. We herein report a case of a 6-year-old boy treated by non-operative management (NOM) for type IIIb pancreatic injury and review 23 pediatric cases of type IIIb pancreatic injury reported in Japan. He presented with upper abdominal pain after blunt abdominal trauma caused by falling in the schoolyard. Abdominal CT examination revealed injury in the pancreatic tail of the main pancreatic duct. He was diagnosed as having type IIIb pancreatic injury and transferred to our hospital. We selected conservative management because his general condition was stable. However, his abdominal pain persisted, and a follow-up CT exam showed two pancreatic pseudocysts. We performed endoscopic-ultrasound-guided drainage and percutaneous transgastric drainage of each pseudocyst. His symptoms disappeared after drainage and he was discharged 50 days after injury. There has been no recurrence of cysts or abdominal symptoms within one year of follow-up. NOM should be considered as a treatment option for type IIIb pancreatic injury depending on the patient’s age, body weight, and general condition.
