Successful endoscopic management of a pediatric intrapancreatic common bile duct stricture following blunt pancreatic trauma: A case report.

Pancreatic and biliary tract injuries from blunt abdominal trauma are rare in children. Common bile duct (CBD) strictures secondary to pancreatic trauma are even more uncommon, and management traditionally involves surgery. We report a 9-year-old boy who developed a severe distal intrapancreatic CBD stricture after blunt pancreatic trauma during an all-terrain vehicle (ATV) accident. Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) demonstrated a 25 mm stricture in the lower CBD. The stricture resolved after two sessions of ERCP with biliary stenting, avoiding surgery. This case highlights a rare but significant delayed biliary complication of pediatric blunt pancreatic trauma. Early recognition and minimally invasive endoscopic intervention can achieve successful stricture resolution and may prevent the need for surgical repair. This case adds to the scarce literature on pediatric traumatic pancreatitis-associated distal CBD stricture managed successfully with ERCP and stenting.