Dirk Schaper, V. Hofmann (Kinderchirurgie St. Barbara-KH Halle)  

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6 Years  

Female  

Abdomen-Pancreas  

physical  

6 years old girl, fall from bicycle, severe abdominal pain, emesis, sweating. Acute admission under suspicion of head injury, abdominal trauma. Abdominal pain on palpation, no bruises, mild resistance.  

N/A  

<- view Ultrasound 1

Ultrasound 1: Incontinuously bordered, echo weak process in the pancreatic tail.



<- view Ultrasound 2

Ultrasound 2: Echogenic and weakened echo structures are shown retrovesically.



<- view Ultrasound 3

Ultrasound 3: Development of a weakened echo, sharply bordered area in the pancreatic body.



<- view Ultrasound 4

Ultrasound 4: Additional development of a further echo weak area rather distant from the organ.



<- view Ultrasound 5

Ultrasound 5: Large echo weak area distant from the organ with connection to the area near the organ.



<- view Ultrasound 6

Ultrasound 6: Findings after aspiration, catheter placement.



<- view Ultrasound 7

Ultrasound 7: Healing with scar tissue.



<- view Ultrasound 8

Ultrasound 8: Healing with colored doppler: vascularisation is held upright.



<- view Ultrasound 9

Ultrasound 9: Left findings, enlargement of teh pancreatic duct.

 

Imaging including endoscopy  

Pancreatic cyst, i.e. due to lymphangioleiomyomatosis, pancreatitis  

After the diagnosis was made, the girl was kept in the intensive care unit for surveillance (rupture depiction, free fluid and clot behind the bladder [Image 1 & 2]). Because of the increasing development of other pseudocysts (Image 3, 4, & 5). an aspiration of the cyst was done. Insertion of a catheter (Image 6); through that healing up of the cyst of the rupture point (Image 7, 8, & 9).  

N/A  

N/A  

1. Medline:
Morise Z, Yamafuji K, Tsuji T, Asami A, Takeshima K, Hayashi N, Baba H, Yoshida F, Abe Y, Tokura Y.
A giant retention cyst of the pancreas (cystic dilatation of dorsal pancreatic duct) associated with pancreas divisum
J Gastroenterol. 2002;37(12):1079-82

2. Medline:
Snajdauf J, Stuj J, Kocmichova B, Rozkova M, Mojzisova M, Keil R, Cumlivska E, Belsan T.
Rupture of the pancreas in children--present trends in diagnosis and therapy
Rozhl Chir. 1999 Oct;78(10):520-4  

Rupture of pancreas, Pancreas pseudocyst, Pancreatic Pseudocyst, Pancreatic rupture, Trauma, Pancreas, Pseudocyst, , child, childhood, pediatric radiology  

Dirk Schaper, V Hofmann. Pancreatic rupture with pseudocyst formation. PedRad [serial online] vol 3, no. 8.
URL: www.PedRad.info/?search=20030830131020