A Late Complication of Blunt Trauma in a Child: Hemorrhagic Pancreatic Pseudocyst

Abstract

Trauma is the most important cause of morbidity and mortality in the pediatric population. Pancreatic injury is relatively rare but has high morbidity and mortality when the diagnosis is delayed. However, diagnosis of pancreatic trauma is difficult. Ultrasound is limited for diagnosing pancreatic injury. Magnetic resonance imaging (MRI) is very useful for detecting direct and secondary signs of pancreatic injury and its complications such as abscess, fistula, pancreatitis, and pseudocyst. We presented a 10-year-old boy with a hemorrhagic pancreatic pseudocyst due to blunt trauma that happened a week ago. His laboratory findings showed elevated serum amylase and lipase levels. In abdominal ultrasonography, bilobular thick-walled fluid collections in the pancreatic parenchyma and peripancreatic location were observed. MRI showed hemorrhagic pseudocysts in the pancreas and pancreatic duct injury. The pseudocysts were treated by cysto-gastrostomy. Children should be carefully evaluated for pancreatic injury and late complications such as hemorrhagic pancreatic pseudocyst to reduce mortality after blunt trauma.