Pediatric Pancreatic and Duodenal Injury

Pancreaticoduodenal injuries present a complex and challenging clinical scenario, often resulting from blunt or penetrating trauma to the upper abdomen. This chapter provides a comprehensive overview of the etiology, diagnosis, and management strategies for pancreaticoduodenal injuries, with a focus on pediatric patients. The retroperitoneal location and intricate anatomical relationships of the pancreas and duodenum pose unique diagnostic and therapeutic challenges. Diagnostic modalities, including imaging studies and clinical assessment, play a crucial role in the early recognition and characterization of injuries. The spectrum of injuries ranges from minor contusions and hematomas to full-thickness lacerations and transections, with varying degrees of associated morbidity and mortality. Non-operative management, including observation and conservative measures, is often appropriate for select cases, while surgical intervention may be necessary for more severe injuries. Operative techniques, such as primary repair, pyloric exclusion, and pancreaticoduodenectomy, are tailored to the extent and severity of the injury. Complications, including intra-abdominal abscesses, fistulas, and duodenal obstruction, require vigilant monitoring and timely intervention. This chapter aims to provide clinicians with a comprehensive understanding of the pathophysiology, diagnosis, and management principles essential for optimizing outcomes in pediatric patients with pancreaticoduodenal injuries.