Imaging description

A 10-year-old boy with a history of a motor vehicle accident presented with abdominal pain and distension. On physical examination he had multiple bruises on his anterior abdominal wall and left flank. CT of the abdomen and pelvis with intravenous contrast (Fig. 55.1) demonstrated a linear area of hypoattenuation extending across the body of the pancreas as well as a small collection of fluid situated between the pancreas and splenic vein. Given the patient’s history of trauma, these findings were consistent with pancreatic fracture.

Importance

The rapid diagnosis of traumatic pancreatic injury either in isolation or in multisystem trauma is essential for limiting the risk of significant morbidity or mortality in pediatric patients. Traumatic injury to the pancreas, especially when associated with injuries to other abdominal organs or rapid intra-abdominal hemorrhage, has a high early mortality rate in children.

Early detection of injury to the pancreatic duct is important as early surgical or medical intervention in the setting of major ductal injury can lessen the risk of pseudocyst, speed overall recovery, and lessen the risk of secondary infection.