An Evaluation of Multidetector Computed Tomography in Detecting Pancreatic Injury: Results of a Multicenter AAST Study

Phelan, Herb A.; Velmahos, George C.; Jurkovich, Gregory J.; Friese, Randall S.; Minei, Joseph P.; Menaker, Jay; Philp, Allan; Evans, Heather L.; Gunn, Martin L.; Eastman, Alexander L.; Rowell, Susan; Allison, Carrie E.; Barbosa, Ronald L.; Norwood, Scott H.; Tabbara, Malek; Dente, Christopher J.; Carrick, Matthew M.; Wall, Matthew J.; Feeney, J.; O’Neill, Patrick J.; Srinivas, Gujjarappa; Brown, Carlos; Reifsnyder, Andrew; Hassan, Moustafa; Albert, Scott P.; Pascual, José L.; Strong, Michelle; Moore, Forrest O.; Spain, David A.; Purtill, Mary Anne; Edwards, Byard; Strauß, J; Durham, Rodney M.; Duchesne, Juan; Greiffenstein, Patrick; Cothren, Clay C.

doi:10.1097/ta.0b013e3181991a0e

Cited by 84 publications

(68 citation statements)

References 16 publications

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“…Low sensitivity for detecting PD injury is still being reported, even with 16 and 64-multidetector CT scanners. 23 Amylase and lipase levels are suggestive of pancreatic injury but are not always diagnostic. 24,25 The optimal management of PD trauma, once a diagnosis has been established, remains unclear owing to the lack of high quality evidence.…”

Section: 13mentioning

confidence: 99%

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

O’Reilly

Bouamra

Kausar

et al. 2015

annals

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INTRODUCTION Pancreatoduodenal (PD) injury is an uncommon but serious complication of blunt and penetrating trauma, associated with high mortality. The aim of this study was to assess the incidence, mechanisms of injury, initial operation rates and outcome of patients who sustained PD trauma in the UK from a large trauma registry, over the period . METHODS The Trauma Audit and Research Network database was searched for details of any patient with blunt or penetrating trauma to the pancreas, duodenum or both. RESULTS Of 356,534 trauma cases, 1,155 (0.32%) sustained PD trauma. The median patient age was 27 years for blunt trauma and 27.5 years for penetrating trauma. The male-to-female ratio was 2.5:1. Blunt trauma was the most common type of injury seen, with a ratio of blunt-to-penetrating PD injury ratio of 3.6:1. Road traffic collision was the most common mechanism of injury, accounting for 673 cases (58.3%). The median injury severity score (ISS) was 25 (IQR: 14-35) for blunt trauma and 14 (IQR: 9-18) for penetrating trauma. The mortality rate for blunt PD trauma was 17.6%; it was 12.2% for penetrating PD trauma. Variables predicting mortality after pancreatic trauma were increasing age, ISS, haemodynamic compromise and not having undergone an operation. CONCLUSIONS Isolated pancreatic injuries are uncommon; most coexist with other injuries. In the UK, a high proportion of cases are due to blunt trauma, which differs from US and South African series. Mortality is high in the UK but comparison with other surgical series is difficult because of selection bias in their datasets.

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Section: 13mentioning

confidence: 99%

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

O’Reilly

Bouamra

Kausar

et al. 2015

annals

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“…Conservative and surgical management of pancreatic trauma in adult patients trauma, presence of pancreatic duct injury or associated bleeding (8)(9)(10)(11). A delay in diagnosis or underestimation of its severity may be responsible for serious complications such as intra-abdominal bleeding, pancreatic fistula or intraabdominal collections (12)(13)(14).…”

Section: Original Articlementioning

confidence: 99%

Conservative and surgical management of pancreatic trauma in adult patients

Menahem¹,

Lim²,

Lahat³

et al. 2016

Hepatobiliary Surg. Nutr.

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IntroductionThe pancreas is an organ located deep in the abdominal cavity, whose anatomical relationship with the digestive and vascular structures (1-4) explains the complexity and severity of pancreatic trauma which represents less than 5% of abdominal trauma (5,6). Pancreatic trauma is potentially lethal when combined with duodenal perforation or closely related arterial bleeding (2,7). These injuries remain difficult to diagnose and undeniably pose a problem in therapeutic strategy. An abdominal computer tomography (CT) allows diagnosis and severity assessments of pancreatic Original Article

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“…The use in decisionmaking for the nonoperative management of pancreatic injuries is therefore limited. 21 Demonstrative CT images of two of the patients treated in the present study are presented in Figs. 1 and 2.…”

Section: Discussionmentioning

confidence: 99%

Blunt pancreatic trauma in children

et al. 2011

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An Evaluation of Multidetector Computed Tomography in Detecting Pancreatic Injury: Results of a Multicenter AAST Study

Abstract: Sixteen and 64-MDCT have low sensitivity for detecting PI and PDI, while exhibiting a high specificity for PDI. Their use as decision-making tools for the nonoperative management of PI are, therefore, limited.

Cited by 84 publications

References 16 publications

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

Conservative and surgical management of pancreatic trauma in adult patients

Blunt pancreatic trauma in children

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