Minimally Invasive Approach to Pediatric Pancreatic Disorders

Abstract

While a pancreatic injury and illness are rare in the pediatric population, episodes of pancreatitis predispose to the development of a pseudocyst. Pseudocysts distinctly lack an epithelial lining, separating them from true cysts. Due to the rarity of pediatric 1 pancreatic pseudocysts, there are still different opinions on optimal management. Additionally, advances in minimally invasive techniques have altered the management. The two most common etiologies of pancreatic pseudocysts in the pediatric population remain acute pancreatitis and blunt abdominal trauma. Traumatic injury causes over 2 sixty percent of pancreatic pseudocyst formation and the majority are a result of abdominal impact with the handlebars of bicycles, followed secondly by falls. A smaller 3 percentage of pediatric pancreatic pseudocysts are idiopathic and may be related to ductal anomalies such as pancreatic divisum. Formation of a pancreatic pseudocyst 4,5 evolves over several weeks following ductal injury or obstruction. The mechanism is pancreatic duct obstruction during injury, inflammation or anatomic anomaly. Clinical manifestations include upper abdominal pain, tenderness, emesis and sometimes an epigastric mass. Pancreatic ascites or a pancreatic pleural effusion are rare. Other 6 potential complications include infection, bleeding and pseudoaneurysm formation.