Pancreatic pseudocyst in children: a single-institute experience

Abstract

Background and objectives: Pancreatic pseudocysts are rare in children, with most series describing not more than 24 patients. At Zagazig University Hospital we have managed a range of cases of this disorder and feel this experience should add to the existing experience with children. This study aimed to analyze the causes, clinical presentation, and management of symptomatic pancreatic pseudocysts treated at our institution.

Patients and methods: This study included 19 children. Their ages ranged from 1 month to 17 years. All cases were diagnosed as pancreatic pseudocysts and were admitted and treated in the Pediatric Surgery Unit, Zagazig University Hospital, during the period from 1996 to 2011. The collected data included age, sex, etiology, clinical presentation, radiological information, operative data, postoperative complications, and the final outcome.

Results: Twelve patients (63.2%) had a history of abdominal trauma, whereas the remaining seven patients (36.8%) had no abdominal trauma. The pseudocysts were acute in 11 patients, chronic in seven patients, and only one patient had congenital pseudocyst. Nine patients improved with expectant treatment; however, 10 patients required surgery. The surgical intervention included  cystogastrostomy for four patients, cystojejunostomy for two patients, complete excision with distal pancreatectomy in two children, and partial excision with external drainage in the remaining two patients. One patient developed postoperative wound infection, and two cases had external pancreatic fistula.

Conclusion: Although spontaneous resolution of pancreatic pseudocysts occurred, more commonly, in acute, small-sized, and post-traumatic cysts, the surgical treatment of pancreatic pseudocyst is a valid, safe, effective, and satisfactory treatment, especially in complicated cases.

Keywords: children, drainage, conservative treatment, pancreatic pseudocyst, pancreatitis, surgical treatment