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目的:探讨儿童外伤性胰腺炎的临床特点及诊治方法。方法:回顾性分析2003年1月—2011年12月收治的13例外伤性胰腺炎患儿的临床资料。结果:13例患儿中,男8例,女5例;年龄5~12(7.22±3.54)岁。病因包括腹部钝挫伤7例,车祸伤4例,坠落伤2例,均为腹部闭合性损伤。9例胰腺Ⅰ级损伤(2例合并肝挫伤)和3例Ⅱ级损伤均采用抗感染、禁食、胃肠减压、全静脉营养,抑酶等保守治疗,其中4例出院1~2个月后并发胰腺假性囊肿,1例经对症治疗自行吸收,3例行囊肿空肠Roux-en-Y吻合术(其中1例腹腔镜下探查拟镜下吻合未成功中转开腹);1例胰腺Ⅲ级损伤(合并脾挫伤)行腹腔镜下腹腔引流术,术后1个月并发胰腺假性囊肿,行腹腔镜探查,囊肿空肠Roux-en-Y吻合术。所有患儿均治愈。结论:儿童外伤性胰腺炎应根据胰腺损伤程度不同采取不同治疗方法。腹腔镜下腹腔引流术是治疗儿童Ⅲ级外伤性胰腺炎的有效方法之一,但与腹腔镜下胰腺假性囊肿空肠吻合术一样仍需要进一步探索与总结。
Objective: To investigate the clinical features and diagnosis and treatment of traumatic pancreatitis in children. Methods: The clinical data of 13 children with traumatic pancreatitis admitted from January 2003 to December 2011 were retrospectively analyzed. Results: Thirteen children, 8 males and 5 females, aged 5 to 12 (7.22 ± 3.54) years. Causes include blunt abdominal trauma in 7 cases, car accidental trauma in 4 cases and crashes in 2 cases, all of which were abdominal closed injuries. Nine cases of pancreatic Ⅰ grade injury (2 cases with liver contusion) and 3 cases of grade Ⅱ injury were used anti-infective, fasting, gastrointestinal decompression, total parenteral nutrition, inhibition of enzyme and other conservative treatment, of which 4 were discharged 1 to 2 Month after the pancreas pseudocyst, 1 case of symptomatic treatment of self-absorption, 3 cases of cystic Roux-en-Y cyst jejunostomy (1 case of laparoscopic exploration under the microscope unsuccessful transit laparotomy); 1 case of the pancreas Ⅲ grade injury (with splenic contusion) laparoscopic abdominal drainage, 1 month after operation complicated with pancreatic pseudocyst, laparoscopic exploration, cyst jejunum Roux-en-Y anastomosis. All children were cured. Conclusion: Children with traumatic pancreatitis should adopt different treatment methods according to the degree of pancreatic injury. Laparoscopic celiac drainage is one of the effective methods for the treatment of grade Ⅲ traumatic pancreatitis in children. However, laparoscopic pseudocyst jejunostomy still needs to be further explored and summarized.