ABSTRACT
Virtually all pancreatic trauma in children is blunt force trauma, at least in the civilised parts of the world, and this is usually applied directly to the epigastrium. The scale of force required for significant injury is very variable. Certainly while motor vehicle accidents (vs. pedestrian) make up a significant proportion of traumatic events, other less innocuous injuries can cause quite devastating injury. The classical cause in older boys involves the bicycle handlebar, either
the headstock or the exposed end. Other well-described scenarios include horse-related trauma involving kickback with the hoof and the lap strap of the seatbelt. The latter may also be associated with an anterior vertebral fracture of L1 or L2 (Chance† fracture). This is important to recognise and has a 20% risk of neurological injury.
