KẾT QUẢ ĐIỀU TRỊ BẢO TỒN CHẤN THƯƠNG TỤY ĐỘ III, IV Ở TRẺ EM TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objectives: Describe the clinical and paraclinical characteristics of patients with grade III and IV pancreatic trauma according to AAST classification and evaluate the results of conservative treatment pancreatic trauma in children at VietDuc University Hospital in the period 2018-2022. Material and method: Retrospective case series of 24 patients with grade III and IV pancreatic trauma on computed tomography (CT) and treated conservatively at the Department of Pediatric and Neonatal Surgery - Viet Duc university Hospital from January 2018 to December 2022. Results: The average age was 10,4 years old, the main cause: traffic accident (95,9%), clinical symptoms: abdominal pain (100%) and abdominal wall abrasions (95,8%). Pancreatic injuries on CT: pancreatic isthmus accounted for 41,7%, body and tail of pancreas 48,3%, AAST classification: 58,3% grade III, 41,7% grade IV. Conservative treatment results: 2 patients required surgery, no patient died. The successful treatment rate was 91,7%, of which 16 patients (66,7%) developed pancreatic pseudocysts and had cyst-gastric drainage via endoscopy. Long-term follow-up from 13 months to 5 years. All patients were stable, and all tests were normal. Conclusion: Conservative treatment of grade III and IV pancreatic injuries in children is feasible and has a high success rate, but treatment should be performed in places with surgical conditions as well as endoscopic intervention and radiological therapy.