operative approach and operative approach. Patients undergoing the operative
approach were divided into pancreatic resection or drain placement only. The
patients who underwent distal pancreatectomy were quicker to attain goal feeds
and discharge to home. Those who underwent a drain placement alone had
similar outcomes to the non-operative group with regard to having prolonged
ileus and protracted lengths of stay. These two groups had similar morbidities
with regard to pseudocyst formation and requirement for intervention such as
percutaneous or endoscopic drainage. Presently, no data exists regarding long
term pancreatic function of these patients.
D. Intestinal Injury
Most intestinal injuries in children are related to a high force blunt injury
such as a direct blow from a fall, handlebar, non-accidental trauma or seat belt.
Distended hollow viscera are more prone to rupture with blunt trauma due to
the increased intra-luminal pressure [37].^ Areas at risk to injury include sites of
mesenteric fixation such as the proximal jejunum near the ligament of Treitz,
the distal ileum near the ileocecal valve, and the rectosigmoid junction. Seat
belt signs may be markers of severe deceleration injury to the abdomen with
associated intra-abdominal blunt hollow viscus injuries, as well as lumbar spine
injuries in approximately 10% of cases; the fractures associated with this
constellation of injuries has the eponym of “Chance” fracture [38]. These
injuries are more prone to occur in young children who are secured in
appropriately, such as adult seat belts without booster seats or using lap belts
marcin
(Marcin)
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