Magnetic Resonance Cholangiopancreatography (MRCP) in the Assessment of Pancreatic Duct Trauma and Its Sequelae: Preliminary Findings

Fulcher, Ann S.; Turner, Mary Ann; Yelon, Jay A.; McClain, L.; Broderick, Timothy J.; Ivatury, Rao R.; Sugerman, Harvey J.

doi:10.1097/00005373-200006000-00002

Cited by 121 publications

(71 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study 21 patients had a full body CT scan, only 1 patient had a CT scan that was consider normal, a false negative rate of 5% which is lower than the data reported in the literature (40%) (8). Also in our series, the diagnosis of pancreatic injury was made by magnetic resonance imaging (MRI) (3 patients), however access to MRI in emergency setting and its yield is under evaluation (23,24). The decision to perform pancreatectomy in the setting of trauma is still a pending question.…”

Section: Discussionmentioning

confidence: 92%

Conservative and surgical management of pancreatic trauma in adult patients

Menahem¹,

Lim²,

Lahat³

et al. 2016

Hepatobiliary Surg. Nutr.

View full text Add to dashboard Cite

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

show abstract

Section: Discussionmentioning

confidence: 92%

Conservative and surgical management of pancreatic trauma in adult patients

Menahem¹,

Lim²,

Lahat³

et al. 2016

Hepatobiliary Surg. Nutr.

View full text Add to dashboard Cite

show abstract

“…However, ERCP and ERCP-assisted interventions may be useful in the conservative treatment of ductal injuries, but as primary diagnostic tools in the emergency situation, they are often not available or too time-consuming. Magnetic resonance tomography and magnetic resonance cholangiopancreatography may in the near future be diagnostic alternatives that – apart from allowing the assessment of pancreatic duct lesions – offer all the diagnostic advantages of an abdominal tomography [18, 19, 20]. Currently, there is a place for CT scans in the diagnosis of pancreatic injuries in the emergency situation, especially since many trauma centers are equipped with fast CT scans.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Injury in Severe Trauma: Early Diagnosis and Therapy Improve the Outcome

Mayer

Tomczak²,

Rau³

et al. 2002

Dig Surg

View full text Add to dashboard Cite

Background: Pancreatic injury is a dangerous complication in multiple injury, and experience with its diagnosis and treatment is usually limited. Method: Retrospective analysis of 3,840 patients admitted after multiple trauma from January 1, 1982, until May 31, 2000. Results: A laparotomy was performed in 121 cases (3.15%) due to suspected intra-abdominal lesion. 32% of the patients (39/121) had a pancreatic lesion; 23% (9/39) had a rupture of the major pancreatic duct. Primary laparotomy was performed in 72% of the patients (28/39). Superficial lesions were treated by explorative laparotomy alone (n = 7), debridement and external drainage (n = 20), or necrosectomy and lavage (n = 3). Complex pancreatic lesions were treated by pancreatojejunostomies (n = 5), pancreatic left resections (n = 2), or exploration alone (n = 2). 8 of 39 patients died (20%), 4 intraoperatively. Of the surviving 35 patients, a pancreas-associated complication developed in 8 patients (23%): pancreatic abscesses (n = 4), traumatic pancreatitis (n = 3), pancreatic fistulas (n = 2), and pseudocysts (n = 2). Conclusions: Pancreatic injury is an infrequent but dangerous complication in severe trauma. Superficial lesions not affecting the major pancreatic duct can be managed by debridement and external drainage. If the major pancreatic duct is ruptured, organ-preserving, complex reconstructive procedures are necessary. When diagnosed timely and treated according to severity and overall situation, pancreatic injuries have an acceptable morbidity, but usually a high mortality.

show abstract

“…In addition, the time taken for MRCP to be performed has restricted its usage to only hemodynamically stable patients. 17 Assessment of the injury includes determining the degree of parenchymal involvement , location of injury within the gland and presence of pancreatic ductal involvement. For grade I and II injuries, adequate hemostasis, debridement and external drainage are usually sufficient.…”

Section: Discussionmentioning

confidence: 99%

Blunt trauma pancreas

Santosh¹,

Thejas²,

Vijayakumar³

et al. 2013

Int J of Biomed & Adv Res

View full text Add to dashboard Cite

The incidence of pancreatic injuries after blunt abdominal trauma is very low, with rates of less than 1% quoted for all trauma admissions. Major injuries of the pancreas are uncommon, but may

result in considerable morbidity and mortality. Due to retroperitoneal location of the organ, symptoms and signs of pancreatic trauma are subtle making diagnosis more difficult and easily missed. Assessment of the injury includes determining the degree of parenchymal involvement , location of injury within the gland and presence of pancreatic ductal involvement. When a pancreatic injury is identified, the method of management is determined by the condition of the patient, the severity of injury and anatomic location. Successful treatment of complex injuries of the pancreas depends largely on initial correct assessment and appropriate treatment. The management of the severe pancreatic injuries remains one of the most difficult challenges in abdominal trauma management.

show abstract

Magnetic Resonance Cholangiopancreatography (MRCP) in the Assessment of Pancreatic Duct Trauma and Its Sequelae: Preliminary Findings

Abstract: MRCP enables noninvasive detection and exclusion of pancreatic duct trauma and pancreas-specific complications and provides information that may be used to guide management decisions.

Cited by 121 publications

References 13 publications

Conservative and surgical management of pancreatic trauma in adult patients

Conservative and surgical management of pancreatic trauma in adult patients

Pancreatic Injury in Severe Trauma: Early Diagnosis and Therapy Improve the Outcome

Blunt trauma pancreas

Contact Info

Product

Resources

About