Pancreatic Trauma

Jh, Patton; Sp, Lyden; Ma, Croce; Fe, Pritchard; Minard, Gayle; Ka, Kudsk; Tc, Fabian

doi:10.1097/00005373-199708000-00005

Cited by 147 publications

(20 citation statements)

References 18 publications

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“…A study by Patton et al likewise found a low mortality rate (1.6%)[12]. However, pancreatic trauma often results in prolonged morbidity [2,13,14].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

Lee

Foo

Lin

et al. 2011

J Trauma Manage Outcomes

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Study objectiveTo assess the efficacy of computed tomography (CT) in evaluating patients with pancreatic trauma.MethodsWe undertook a retrospective review of all blunt trauma patients admitted to the Chi-Mei Medical Center from January 2004 to June 2006. Every patients underwent abdominal CT scan in emergency department and the CT scans were obtained with a four-slice helical CT. Diagnosis of a pancreatic injury in these patients was by surgical observation or by CT findings. Radiographic pancreatic injuries were classified as deep or superficial lesions. Deep lesions were defined as the hematomas or lacerations >50% thickness of the pancreas. Superficial lesions were described as the hematomas or lacerations <50% thickness of the pancreas; pancreatic edema; and focal fluid accumulation around the pancreasResultsNineteen patients with pancreatic trauma, fourteen males and five females, average age 40.6 ± 21.4 years, were included. Most patients (73.7%) with pancreatic trauma had associated organ injuries. CT was performed in all patients and laparotomy in 14 patients. CT was 78.9% sensitive in detecting pancreatic trauma. All deep pancreatic lesions revealed on CT required surgical treatment, and complication was discovered in two patients undergoing delayed surgery. Superficial lesions were managed conservatively.ConclusionFour-slice helical CT can detect most pancreatic trauma and provide practical therapeutic guidance. Delayed operation might result in complications and is associated with prolonged hospital stays.

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“…A study by Patton et al likewise found a low mortality rate (1.6%)[12]. However, pancreatic trauma often results in prolonged morbidity [2,13,14].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

Lee

Foo

Lin

et al. 2011

J Trauma Manage Outcomes

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“…Frequencies of pancreatic injuries are related to the geographic settings of the traumatic incidents (i.e., urban or rural). In the U.S.A., penetrating trauma accounts for 70% of all pancreatic injuries, and blunt trauma accounts for the remaining 30% (3, 7, 8). However, in our series, 92% of all pancreatic injuries were caused by blunt trauma and the remaining 8% by penetrating trauma.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, the status of the main pancreatic duct is an important predictor of outcome, and knowledge of its status is essential for establishing a basis for treatment decisions in cases of pancreatic injury (1-3, 8-10). Bradley et al (9) reported a significant association between main pancreatic ductal injury and an increased incidence of pancreas-related complications, particularly, with an increased incidence of pancreatic fistula.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Determinants in Patients with Traumatic Pancreatic Injuries

Hwang

Choi

2008

J Korean Med Sci

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The aim of this study was to identify factors that predict morbidity and mortality in patients with traumatic pancreatic injuries. A retrospective review was performed on 75 consecutive patients with traumatic pancreatic injuries admitted to the Emergency Medical Center at Masan Samsung Hospital and subsequently underwent laparotomy during the period January 2000 to December 2005. Overall mortality and morbidity rates were 13.3% and 49.3%, respectively. A multivariate regression analysis revealed that greater than 12 blood transfusions and an initial base deficit of less than -11 mM/L were the most important predictors of mortality (p<0.05). On the other hand, the most important predictors of morbidity were surgical complexity and an initial base deficit of less than -5.8 mM/L (p<0.01). These data suggests that early efforts to prevent shock and rapidly control of bleeding are most likely to improve the outcome in patients with traumatic pancreatic injuries. The severity of pancreatic injury per se influenced only morbidity.

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“…[1] The incidence is higher in penetrating injuries, ranging from 1% to 12% in published series. [12]…”

Section: Introductionmentioning

confidence: 99%

“…[3] Morbidity rates due to pancreatic trauma approach up to 45%. [23456] In cases of delayed treatment, this may increase to 60%. [456]…”

Section: Introductionmentioning

confidence: 99%

Management and outcome of patients with pancreatic trauma

Singh¹,

Mahajan²,

Selhi³

et al. 2017

Niger J Surg

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Introduction:Pancreatic trauma is a rare entity occurring in 0.2% of patients with blunt trauma abdomen. Once the diagnosis is made, the management of patients is dependent on multiple variables. Conservative management, suture repair, drainage, and resection have been utilized with varying degree of success. This study is aimed to evaluate the management of patients with pancreatic trauma.Materials and Methods:This was a prospective study done in the Department of Surgery in Dayanand Medical College and Hospital where forty hemodynamically stable patients diagnosed to have pancreatic trauma on contrast-enhanced computed tomography abdomen were included in the study.Results:Out of forty patients taken in this study, 38 were male and two were female with age ranging from 3 to 50 years. Road traffic accident was the most common cause of pancreatic injury. Pancreatic injuries were graded according to the American Association for Surgery in Trauma scale. Twelve patients had Grade I and II injuries. Grade III was the most common injury occurring in 14 patients. Twenty-four patients underwent surgical management. Mortality rate was 45% and it was in direct correlation with the severity of injury.Conclusion:Grade I and II pancreatic injury can be managed conservatively depending upon the hemodynamic status of the patient. Grade III and IV injuries have a better prognosis if managed surgically.

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Pancreatic Trauma

Abstract: Pancreatic injuries including those with indeterminate ductal status can be successfully managed with low morbidity and mortality using this simplified management protocol.

Cited by 147 publications

References 18 publications

The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

Prognostic Determinants in Patients with Traumatic Pancreatic Injuries

Management and outcome of patients with pancreatic trauma

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