Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis

Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was...

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Main Authors: Michelle J. Hong, Lauren M. Porter, Debra D. Esernio-Jenssen, Andrew C. Miller, Marna Rayl Greenberg
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2017/2681835
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author Michelle J. Hong
Lauren M. Porter
Debra D. Esernio-Jenssen
Andrew C. Miller
Marna Rayl Greenberg
author_facet Michelle J. Hong
Lauren M. Porter
Debra D. Esernio-Jenssen
Andrew C. Miller
Marna Rayl Greenberg
author_sort Michelle J. Hong
collection DOAJ
description Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen. On further inquiry specific to trauma, the child disclosed that his older brother had punched him in his abdomen the night before. The child’s parents were separated due to intimate partner violence, and this older sibling recently had been very stressed. The sibling was referred for mental health evaluation and counseling, and the case reported to the county children and youth investigative services system. A low threshold for considering trauma and child abuse in the pediatric population is recommended when significant intra-abdominal injury is diagnosed.
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spelling doaj-art-af2cfc8403094dc8878ad20464f180e32025-02-03T05:47:21ZengWileyCase Reports in Pediatrics2090-68032090-68112017-01-01201710.1155/2017/26818352681835Pancreatic Laceration in a Pediatric Patient: An Unexpected DiagnosisMichelle J. Hong0Lauren M. Porter1Debra D. Esernio-Jenssen2Andrew C. Miller3Marna Rayl Greenberg4Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, USF MCOM, CC & I-78, Allentown, PA 18103, USADepartment of Emergency Medicine, Lehigh Valley Hospital and Health Network, USF MCOM, CC & I-78, Allentown, PA 18103, USADepartment of Pediatrics, Lehigh Valley Hospital and Health Network, USF MCOM, CC & I-78, Allentown, PA 18103, USADepartment of Emergency Medicine, Lehigh Valley Hospital and Health Network, USF MCOM, CC & I-78, Allentown, PA 18103, USADepartment of Emergency Medicine, Lehigh Valley Hospital and Health Network, USF MCOM, CC & I-78, Allentown, PA 18103, USAPediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen. On further inquiry specific to trauma, the child disclosed that his older brother had punched him in his abdomen the night before. The child’s parents were separated due to intimate partner violence, and this older sibling recently had been very stressed. The sibling was referred for mental health evaluation and counseling, and the case reported to the county children and youth investigative services system. A low threshold for considering trauma and child abuse in the pediatric population is recommended when significant intra-abdominal injury is diagnosed.http://dx.doi.org/10.1155/2017/2681835
spellingShingle Michelle J. Hong
Lauren M. Porter
Debra D. Esernio-Jenssen
Andrew C. Miller
Marna Rayl Greenberg
Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
Case Reports in Pediatrics
title Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
title_full Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
title_fullStr Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
title_full_unstemmed Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
title_short Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis
title_sort pancreatic laceration in a pediatric patient an unexpected diagnosis
url http://dx.doi.org/10.1155/2017/2681835
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AT debradeserniojenssen pancreaticlacerationinapediatricpatientanunexpecteddiagnosis
AT andrewcmiller pancreaticlacerationinapediatricpatientanunexpecteddiagnosis
AT marnaraylgreenberg pancreaticlacerationinapediatricpatientanunexpecteddiagnosis