CAPS papersUtility of amylase and lipase as predictors of grade of injury or outcomes in pediatric patients with pancreatic trauma
Section snippets
Methods
This was a multicenter retrospective review from 9 pediatric trauma centers (see participating centers in acknowledgements). All contributing centers are members of the American Pediatric Surgery Association Trauma Committee. Institutional review board approval was obtained at each center. Each institution collected data on children (<18 years old) with a documented pancreatic injury. A common data collection form was used, and 5 years of data was collected (2003-2008). The data were then sent
Results
The study took place between 2003 and 2008. One hundred thirty-one cases were submitted. There were 85 boys, 44 girls, and 2 cases where the gender was not recorded. The average age was 9.0 ± 0.4 years (mean ± SD). The mean ± SD ISS score was 15.5 ± 1.2. There were 12 deaths. Motor vehicle collisions and bicycle crashes were the most common injury mechanisms. For this study, 111 cases had complete data for amylase, and 91 had complete data for the lipase evaluation. The total number of patients
Discussion
In December 2008, the World Health Organization released the “World Report on Child Injury Prevention” that established injury as the number 1 pediatric public health problem in the world [16]. Despite this report, national authorities have identified not only critical deficiencies in pediatric trauma care but also insufficient research to address these deficiencies. One factor that contributes to this problem is the limited number seriously injured children treated at a single center [17].
Acknowledgments
The authors thank the members of the American Pediatric Surgical Association Committee on Trauma Participating Institutions and Surgical Leads: David P. Mooney, MD (Boston Children's Hospital, Boston, MA); Randall Burd, MD (Childrens National Medical Center, Washington, DC); Robert Letton, MD (Oklahoma Children's Hospital, Oklahoma City, OK); Katheryn Bass, MD (Cook Children's Hospital, Chicago, IL); Mindy Statter, MD (Comer Children's Hospital at the University of Chicago, Chicago, IL);
References (28)
- et al.
Pancreatic trauma in children
J Pediatr Surg
(2004) - et al.
Pediatric pancreatic trauma: predictors of nonoperative management failure and associated outcomes
J Pediatr Surg
(2007) - et al.
Serum amylase and lipase alone are not cost-effective screening methods for pediatric pancreatic trauma
J Pediatr Surg
(2003) - et al.
Operative vs nonoperative management of blunt pancreatic trauma in children
J Pediatr Surg
(2010) - et al.
Organ injury scaling
Surg Clin North Am
(1995) - et al.
Early operation in children with pancreatic transaction
J Pediatr Surg
(2001) - et al.
Non-operative management of pancreatic injuries in children
J Pediatr Surg
(1998) - et al.
Significance of serum amylase level in evaluating pancreatic trauma
Am J Surg
(1975) - et al.
The utility of routine trauma laboratories in pediatric trauma resuscitations
Am J Surg
(2004) - et al.
Management of pancreatic injury in pediatric blunt abdominal trauma
J Pediatr Surg
(1999)
Emergency medical services for children
Variation in the management of pediatric splenic injuries in the United States
J Trauma
Diagnosis and initial management of blunt pancreatic trauma: guidelines from a multi-institutional review
Ann Surg
Amylase and lipase measurements in paediatric patients with traumatic pancreatic injuries
Injury Int J Care Injured
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2016, PancreatologyCitation Excerpt :A recent multicentric study confirmed the limited value of routine and serial amylase and lipase measurements in the management of pancreatic injury. However, a maximum amylase level of 1100 U/L seems to be predictive of pseudo-cyst development [18]. In the setting of pancreatic trauma, ultrasound is considered to be a less than optimal diagnostic tool.
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