Imaging of blunt pancreatic trauma

Rekhi, Satinder S.; Anderson, Stephan W.; Rhea, James T.; Soto, Jorge A.

doi:10.1007/s10140-009-0811-0

Cited by 63 publications

(41 citation statements)

References 23 publications

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“…41 CT findings of pancreatic trauma can be broadly categorized as direct or "hard" signs, such as a pancreatic laceration, which tends to be specific but lacks sensitivity, or as indirect or "soft" signs, such as peripancreatic fluid, which tends to be sensitive but lacks specificity. 37,42,43 However, newer multidetector CT may have sensitivities approaching 80% and higher specificity for ductal injury. 23,43 A CT-based score proposed that parenchymal transection of over 50% of the pancreatic gland had a high risk of ductal disruption, 44 but was based on CT-technology that is currently surpassed.…”

Section: Diagnostic Modalities and Investigationmentioning

confidence: 99%

Clinical update on management of pancreatic trauma

Søreide

Weiser

Parks

2018

HPB

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Section: Diagnostic Modalities and Investigationmentioning

confidence: 99%

Clinical update on management of pancreatic trauma

Søreide

Weiser

Parks

2018

HPB

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“…2 Specific signs of injury include fractures or lacerations of the pancreas, active hemorrhage from the gland, or contusion, edema or hematoma of the parenchyma. Pancreatic injuries are generally recognized either by computed tomographic (CT) scan or at exploratory laparotomy (LAP).…”

Section: Annotated Text For the Algorithmmentioning

confidence: 99%

Western Trauma Association Critical Decisions in Trauma

Biffl

Moore

Croce

et al. 2013

Journal of Trauma and Acute Care Surgery

124

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The American College of Surgeons designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Crediti. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Of the AMA PRA Category 1 Crediti listed above, a maximum of 1 credit meets the requirements for self-assessment. ObjectivesAfter reading the featured articles published in the Journal of Trauma and Acute Care Surgery, participants should be able to demonstrate increased understanding of the material specific to the article. Objectives for each article are featured at the beginning of each article and online. Test questions are at the end of the article, with a critique and specific location in the article referencing the question topic. Claiming CreditTo claim credit, please visit the AAST website at http://www.aast.org/ and click on the Be-Learning/MOC[ tab. You must read the article, successfully complete the post-test and evaluation. Your CME certificate will be available immediately upon receiving a passing score of 75% or higher on the post-test. Post-tests receiving a score of below 75% will require a retake of the test to receive credit. This algorithm was presented at the annual meeting of the Western Trauma Association, March 3Y8, 2013, in Snowmass, Colorado. The Western Trauma Association (WTA) develops algorithms to provide guidance and recommendations for particular practice areas but does not establish the standard of care.The WTA algorithms are based on the evidence available in the literature and the expert opinion of the task force in the recent time frame of the publication. The WTA considers use of the algorithm to be voluntary. The ultimate determination regarding its application is to be made by the treating physician and health care professionals with full consideration of the individual patient's clinical status as well as available institutional resources; it is not intended to take the place of health care providers' judgment in diagnosing and treating particular patients.

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“…In these cases, it is advisable to repeat the CT 12 hours later, when the CT accuracy is more reliable (Rekhi, 2010;Sheikh, 2015). 17,18 In the hospital where this study was conducted, the CT is used as an initial method of choice for all cases. The ERCP is not entirely available at the João XXIII Hospital, but, if necessary, it can be performed in partner hospitals.…”

Section: Discussionmentioning

confidence: 99%

Conservative Treatment of Pancreatic Trauma–An Experience from a Brazilian Trauma Center

Botelho-Filho¹,

Drumond²,

Starling³

et al. 2018

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Introduction:This study wants to demonstrate that it is safe to treat pancreatic trauma conservatively in a developing country where resources are challenging. Materials and Methods:The study analyzed data from a Brazilian trauma center.Results: Thirteen patients from 2006 to 2017 had pancreatic trauma from low (I and II) and high grade (III) lesions and were treated conservatively. There was no mortality. Four patients had complications, but only one required laparotomy. In the study, a relationship was found with the degree of injury and time of hospitalization (p < 0.011), in addition to the presence of complications with the degree of complication (p < 0.021). Conclusion:Conservative treatment of pancreatic trauma has been performed in low and high grade lesions. It is believed that as long as there is a 24-hour surgical team, such as computed tomography (CT), the treatment of pancreatic trauma can be well-conducted. Clinical Significance:The study can decrease the number of unnecessary laparotomies.Objetivo: Este estudo quer demonstrar que é seguro tratar o trauma pancreático de forma conservadora em um país em desenvolvimento onde os recursos são desafiadores. Materiais e Métodos: O estudo analisou dados de um centro de trauma brasileiro.Resultados: Treze pacientes de 2006 a 2017 apresentaram trauma pancreático de baixo (I e II) e de alto grau (III), sendo tratados de forma conservadora. Não houve mortalidade. Quatro pacientes apresentaram complicações, mas apenas em um caso foi necessária laparotomia. No estudo, encontrou-se um relacionamento com o grau de lesão e tempo de internação (p 0,011), além da presença de complicações com o grau de complicação (p 0,021).Conclusão: o tratamento conservador do trauma pancreático é factível em lesões de baixo e alto grau. Acredita-se que, se houver uma equipe cirúrgica de 24 horas, com TC, o tratamento do trauma pancreático pode ser bem conduzido. Significância clínica: o estudo pode a diminuir o número de laparotomias desnecessárias.

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Imaging of blunt pancreatic trauma

Cited by 63 publications

References 23 publications

Clinical update on management of pancreatic trauma

Clinical update on management of pancreatic trauma

Western Trauma Association Critical Decisions in Trauma

Conservative Treatment of Pancreatic Trauma–An Experience from a Brazilian Trauma Center

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