Factors Affecting Outcome in Pancreatic Trauma

Eh, Sims; Mandal, AK; Schlater, Theodore L.; Aw, Fleming; Ma, Lou

doi:10.1097/00005373-198402000-00006

Cited by 51 publications

(33 citation statements)

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“…Such complications would be responsible for a death rate of more than 20% [22]. On the contrary, according to several authors an isolated trauma of the pancreas cannot be responsible for a rapid death [12,22,23], but can result in numerous complications (19-25% of cases) [11,13], mainly fistular and also acute pancreatitis and abcesses, with a rate of delayed death estimated at 9% [19,23]. These complications can be explained by the occurrence of a necrosis of the gland by its own enzymes, linked to a parenchymatous rupture affecting the acini, or to a rupture of a duct.…”

Section: Discussionmentioning

confidence: 99%

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Fatal blunt pancreatic trauma secondary to assault and battery: a case report

Rougé-Maillart

Tracqui²,

Tortel³

et al. 2001

International Journal of Legal Medicine

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The authors report on an fatal case of closed trauma of the pancreas in a context of violence. A 55-year-old man was found unconscious on the sidewalk and died a short time after being taken to the hospital. He had been hit with several punches to the face and abdomen 6 h before. The post-mortem examination showed numerous bruises over the whole body, a haemoperitoneum, a fissuration of the spleen and a massive peripancreatic haemorrhage associated with a complete dilaceration of the pancreas head. Histological examination of the pancreas revealed a massive necrosis associated with a subtotal disappearance of the acini, numerous sites of cytosteatonecrosis and a large haemorrhagic suffusion of the peripancreatic tissue. This case illustrates the possibilities of pancreatic injuries induced by blunt force aimed at the abdomen in a context of violence. Even if this occurs as an isolated injury it can result in rapid death because of the particular type of pancreatic fracture which is frequently involved. In postmortem situations, the pancreas should be systematically checked at necropsy and a histological examination should be carried out at the slightest doubt of a pancreatic lesion or suspicion of blunt force abdominal injuries.

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Section: Discussionmentioning

confidence: 99%

“…These complications can be explained by the occurrence of a necrosis of the gland by its own enzymes, linked to a parenchymatous rupture affecting the acini, or to a rupture of a duct. This phenomenon may be delayed for 12 days up to 6 months [11,22,23] and is classically not involved in premature deaths.…”

Section: Discussionmentioning

confidence: 99%

Fatal blunt pancreatic trauma secondary to assault and battery: a case report

Rougé-Maillart

Tracqui²,

Tortel³

et al. 2001

International Journal of Legal Medicine

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“…3 b) der externen oder internen Drainage vorgezogen [5,10,18] [15]. Auch Schä digungen des Pankreaskopfes (Grad III) ohne Gangbeteiligung sollten konservativ durch Dé bridement und Drainage versorgt werden [18].…”

Section: Therapieunclassified

Verletzungen des Pankreas

Jacobi

Nagel

Saeger

1997

Chirurg

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Injuries of the pancreas seldom occur in connection with abdominal trauma (12%), but they are difficult to diagnose. There is a high complication rate (35%) after such injuries. Ultrasound, CT and other means of diagnosis are only helpful in making the diagnose only in 60-80%. A clinical examination is difficult in such patients, as they often have multiple injuries. We discuss 10 cases with different grades of pancreatic injuries (Lucas), their therapy with special attention to the diagnosis, time of laparotomy, exploration of the pancreas during operative intervention, the extent of treatment and the management of complications.

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“…In many cases the surgical management is relatively simple, but occasionally complex and technical surgical solutions are necessary and the position of the pancreas makes its access and all procedures on it challenging. To compound this, pancreatic trauma is associated with a high incidence of injury to adjoining organs and major vascular structures, which adds to the high morbidity and mortality, and complications occur in 30-60% of patients [1,2]. …”

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confidence: 99%

Injuries to the Pancreaticoduodenal Complex

Boffard

2008

Eur J Trauma Emerg Surg

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Injuries to the pancreaticoduodenal complex present a significant challenge both in diagnosis and management. The retroperitoneal location of the pancreas means that it is not a common site of injury, but this also contributes to the difficulty in diagnosis, as the organ is concealed, and investigation often results in delay with its attendant increase in morbidity. The increase in violence in society, particularly of penetrating injuries and the increase in energy of wounding from gunshots, has made pancreatic injury more common. In many cases the surgical management is relatively simple, but occasionally complex and technical surgical solutions are necessary and the position of the pancreas makes its access and all procedures on it challenging. To compound this, pancreatic trauma is associated with a high incidence of injury to adjoining organs and major vascular structures, which adds to the high morbidity and mortality, and complications occur in 30-60% of patients [1, 2].

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Factors Affecting Outcome in Pancreatic Trauma

Cited by 51 publications

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Fatal blunt pancreatic trauma secondary to assault and battery: a case report

Fatal blunt pancreatic trauma secondary to assault and battery: a case report

Verletzungen des Pankreas

Injuries to the Pancreaticoduodenal Complex

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