Pancreatic injury is rare in pediatric cases of blunt abdominal trauma and nonoperative management is preferred in pediatric patients. There are more concerns about operative treatment observed in pediatric patients compared with adult patients. However, some pediatric cases require surgical treatment. If distal pancreatectomy is performed, the necessity of splenectomy should be considered, especially in pediatric patients. This study reports the case of a 17-month-old patient with a Grade 3 pancreatic injury following blunt abdominal trauma. The patient was successfully managed by spleen-preserving distal pancreatectomy. In conclusion, this surgical technique can be performed safely, and complications caused by splenectomy can be prevented using this technique.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective resuscitative modality to temporize noncompressible truncal hemorrhage. Confirming the proper position of the balloon catheter in the target aortic zone is vital. Currently, there is a need for nonradiographical methods. This would overcome the drawbacks of conventional imaging modalities, such as fluoroscopy. Several studies have suggested ultrasound-guided visualization via subxiphoid, transperitoneal, or transesophageal views as an alternative to conventional imaging methods. However, such views are easily obscured in emergency settings. Herein, we report the case of a 70-year-old patient who was successfully resuscitated by REBOA under the guidance of transsplenic ultrasound. REBOA was safely performed using transsplenic visualization without fluoroscopy.

Citations

• Resuscitative endovascular balloon occlusion of the aorta in abdominal trauma: zone-specific outcomes and predictors of mortality
  Musaed Rayzah, Nasser A. N. Alzerwi, Bandar Idrees, Ahmed A. Alhumaid, Yaser Baksh, Fares Rayzah
  International Journal of Emergency Medicine.2026;[Epub]     CrossRef

Purpose
Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding.
Methods
This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)].
Results
The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG.
Conclusion
The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.