Comparison of diagnostic imaging modalities for the evaluation of pancreatic duct injury in children: a multi-institutional analysis from the Pancreatic ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-08-03

AUTHORS

Eric H. Rosenfeld, Adam Vogel, Robert T. Russell, Ilan Maizlin, Denise B. Klinkner, Stephanie Polites, Barbara Gaines, Christine Leeper, Stallion Anthony, Megan Waddell, Shawn St. Peter, David Juang, Rajan Thakkar, Joseph Drews, Brandon Behrens, Mubeen Jafri, Randall S. Burd, Marianne Beaudin, Laurence Carmant, Richard A. Falcone, Suzanne Moody, Bindi J. Naik-Mathuria

ABSTRACT

PurposeDetermining the integrity of the pancreatic duct is important in high-grade pancreatic trauma to guide decision making for operative vs non-operative management. Computed tomography (CT) is generally an inadequate study for this purpose, and magnetic resonance cholangiopancreatography (MRCP) is sometimes obtained to gain additional information regarding the duct. The purpose of this multi-institutional study was to directly compare the results from CT and MRCP for evaluating pancreatic duct disruption in children with these rare injuries.MethodsRetrospective study of data obtained from eleven pediatric trauma centers from 2010 to 2015. Children up to age 18 with suspected blunt pancreatic duct injury who had both CT and MRCP within 1 week of injury were included. Imaging findings of both studies were directly compared and analyzed using descriptive statistics, Chi square, Wilcoxon rank-sum, and McNemar’s tests.ResultsData were collected for 21 patients (mean age 7.8 years). The duct was visualized more often on MRCP than CT (48 vs 5%, p < 0.05). Duct disruption was confirmed more often on MRCP than CT (24 vs 0%), suspected based on secondary findings equally (38 vs 38%), and more often indeterminate on CT (62 vs 38%). Overall, MRCP was not superior to CT for determining duct integrity (62 vs 38%, p = 0.28).ConclusionsIn children with blunt pancreatic injury, MRCP is more useful than CT for identifying the pancreatic duct but may not be superior for confirmation of duct integrity. Endoscopic retrograde cholangiogram (ERCP) may be necessary to confirm duct disruption when considering pancreatic resection.Level of evidenceIII. More... »

PAGES

961-966

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00383-018-4309-2

DOI

http://dx.doi.org/10.1007/s00383-018-4309-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105973859

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30074080


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372 grid-institutes:grid.416975.8 schema:alternateName Texas Children’s Hospital and the Michael E DeBakey Department of Surgery, 6701 Fannin Street # 1210, 77030, Houston, TX, USA
373 schema:name Texas Children’s Hospital and the Michael E DeBakey Department of Surgery, 6701 Fannin Street # 1210, 77030, Houston, TX, USA
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375 grid-institutes:grid.427669.8 schema:alternateName Carolinas HealthCare System, Charlotte, NC, USA
376 schema:name Carolinas HealthCare System, Charlotte, NC, USA
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378 grid-institutes:grid.461393.a schema:alternateName Randall Children’s Hospital at Legacy Emanuel Medical Center, Portland, OR, USA
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381 grid-institutes:grid.66875.3a schema:alternateName Mayo Clinic, MN, Rochester, USA
382 schema:name Mayo Clinic, MN, Rochester, USA
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