Pediatric Pancreatic Trauma

  • Etiology: blunt abdominal trauma
  • Imaging: spectrum is contusion (pancreatic enlargement) / laceration / fracture, best indicators for injury is fluid in lesser sac or anterior pararenal space or anterior to the portal vein, peripancreatic fluid collection / pseudocyst, CT findings of focal areas of decreased enhancement can be subtle or absent initially
  • Note: absence of peripancreatic fluid does not exclude pancreatic trauma
  • Clinical: most common cause of pancreatitis in children

Radiology Cases of Pancreatic Trauma

CT and US of pancreatic trauma / traumatic pancreatitis
Axial CT with contrast of the abdomen (above) shows an enlarged pancreatic head with some mild intrahepatic biliary dilation and non-visualization of the common bile duct. Transverse US of the pancreas obtained a day later (below) shows an enlarged hypoechoic pancreatic head.
CT of pancreatic trauma / pancreatic laceration
Axial CT with contrast of the abdomen shows a linear low density just anterior to the portal vein at the junction of the pancreatic head and pancreatic body. There is a large amount of peripancreatic fluid.