Abstract
This report combines the findings and treatment in 15 infants and children with pancreatic pseudocysts with 60 additional cases from a literature review. The mean age at diagnosis was 7.5 years with pseudocyst being more common in boys (44:31). Sixty per cent were due to trauma, while in 32% the cause was unknown. Abdominal pain (68%), a mass (64%), and vomiting (52%) were the most frequent findings. The serum amylase was elevated and the upper gastrointestinal contrast study consistent with a mass in 88% of cases. Operative treatment included external drainage in 25 children (33%), cystgastrostomy or cyst-jejunostomy in 34 (45%), excision in 10 (13%) and miscellaneous procedures in 6 (8%). Complications were relatively few and there were no deaths recorded. Recurrence rate for cyst-gastrostomy was 4.7%, cyst-jejunostomy 7.6%, external drainage 8% and cyst-duodenostomy 50%. External drainage operations had prolonged cutaneous drainage. These observations suggest the appropriate operation is determined by the location and duration of pseudocyst. Internal drainage is preferred and avoids complications seen following resection and external drainage. Cyst-gastrostomy is effective when the pseudocyst is retrogastric and adherent to ...Continue Reading
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