Pancreatic injury in pediatric blunt abdominal trauma is rare.
This study was a secondary analysis of the data collected by the Pediatric Emergency Care Applied Research Network (PECARN) in the Intra-abdominal Injury Study Group. Of the children who had blunt abdominal trauma, 6% had intraabdominal injuries and 1% had pancreatitis. A patient was considered as having traumatic pancreatitis if they had 2 of the following: 1) upper abdominal tenderness, 2) serum lipase of amylase > 3 x the upper limit of normal or 3) imaging study positive for pancreatitis.
Additional Information
Children diagnosed with pancreatitis were more likely to report abdominal pain, vomiting, shortness of breath, thoracic trauma and handlebar injury compared to those without a diagnosis of pancreatitis. On exam, they were more likely to be hypotensive, tachypneic, evidence of abdominal wall injury, costal tenderness, abdominal distention and abdominal tenderness. When the PECARN prediction rule was applied to these patients, the sensitivity was 99% with a specificity of 42%. The rule missed one patient who had traumatic pancreatitis, but this patient did not meet the definition for clinically important abdominal injury (requiring therapeutic laparotomy, embolization, blood transfusion or requiring IV fluids for > 2 days).
References
Marks MS, Liveris A, Blumberg SM, Reddy SH, Meltzer JA. Predicting Pancreatitis in Children With Blunt Abdominal Trauma. Pediatr Emerg Care. 2025 Jun 6. doi: 10.1097/PEC.0000000000003421. Epub ahead of print. PMID: 40476662.
