Child’s pancreatic post-traumatic pseudocyst

Abstract

Background. The pancreatic pseudocyst is one of the most common complications of parenchymal organ trauma and is a fluid collection located intra-or per pancreatic. The medical and surgical treatment derives from diagnostic aspects, medical imaging and laboratory data. Objective of the study. To present the clinical –paraclinical and treatment peculiarities of the pancreatic post-traumatic pseudocyst. Material and Methods. In 2010-2020, 26 patients with post-traumatic pancreatic pseudocysts were hospitalized, 17 received conservative treatment.The etiology was specified in 19 cases. It was more prevalent among males as a result of abdominal injuries. The symptoms were dominated by abdominal pain. The diagnosis of desease was confirmed by abdominal ultrasound, CT and NMR within 14 days after the onset of trauma. Results. Therapeutic indications were based on clinical criteria, ultrasound, CT with angiography, which allowed the evaluation of volume changes of the pancreartic pseudocyst. Spontaneous involution was observed at 17 patients within 12-16 weeks after the onset. The external drainage was the optimal surgical procedure for pseudocyst in 9 cases. Conclusion. Therapeutic options were based on clinical-paraclinical observations over time. Spontaneous evolution occurs in posttraumatic pancreatic pseudocyst with a diameter if less than 5 cm. The external drainage remains the surgical solution of choice in mature posttraumatic pancreatic pseudocysts. Introducere. Pseudochistul pancreatic, una dintre cele mai frecvente complicații ale traumatismului organelor parenchimatoase, reprezintă o colecție lichidiană, localizată intra- sau peripancreatic. Tratamentul medico-chirurgical derivă din aspectele diagnostice, imagistice, din datele de laborator. Scopul lucrării. Prezentarea particularităților clinico-paraclinice și de tratament a pseudochistului postraumatic pancreatic. Material și Metode. În 2010-2020 au fost spitalizați 26 pacienți cu pseudochisturi pancreatice posttraumatice,17 au fost tratați conservator. Etiologia a fost precizată la 19. Prevala sexsul masculin ca rezultat al diferitor traumatisme abdominale. Simptomatologia a fost dominată de dureri abdominale. Ecografia, CT, RMN au precizat diagnosticul de pseudochist al pancreasului la 14 zile de la debutul traumatismului. Rezultate. Indicațiile terapeutice au fost bazate pe criteriile clinice, ecografice, CT cu angiografie, care au permis evaluarea modificărilor de volum ale pseudochistului pancreatic. Involuția spontană a avut loc la 17 pacienți, după o evoluție de 12-16 săptămâni de la debut. Procedeul optim chirurgical a pseudochistului la 9 pacienți a fost drenajul extern. Concluzii. Opțiunile terapeutice au fost bazate pe manifestările clinico-paraclinice în timp. Evoluția spontană a avut loc în pseudochisturile posttraumatice pancreatice cu diametru de sub 5 cm. În pseudochisturile pancreatice posttraumatice mature, drenajul extern rămâne soluția chirurgicală de elecție.