小児外傷性膵仮性嚢肥の2例

概要

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Case 1: A 9-year-old boy fell off his bicycle and hit his abdomen against the handlebar. He complained of abdominal pain, which subsided within a few days. After an intermission of 3 months, abdominal distension was observed and pancreatic pseudocyst was diagnosed for the first time by ultrasonography. External drainage was performed successfully. Case 2: A 5-year-old boy was transferred from the other hospital 2 days after blunt abdominal trauma. He also fell off his bicycle. Serum amylase was elevated and traumatic pancreatic pseudocyst was diagnosed by ultrasonography. The patient was treated conservatively at first. His clinical course was satisfactory until 4 weeks after admissiom, when epigastralgia and abdominal distension recurred. Cystogastrostomy was carried out in emergency. His postoperative course was uneventful. Traumatic pancreatic pseudocyst is uncommon in children. Both of 2 cases presented here was correctly diagnosed by ultrasonography. The authors believe that the ultrasonography is the most reliable and non-invasive method for diagnosis of traumatic pancreatic pseudocyst. There still remain many difficulties for the management of pancreatic pseudocyst and also traumatic pancreatitis in children. Although it might be important to allow the time for the capsule of the pseudocyst to mature, the proper timing of surgery should not be missed.
日本小児外科学会の論文
1983-05-20