Penetrating Pancreatic Injury

DiGiacomo, Lillian; Schreiber, Martin A.

doi:10.1007/s40719-015-0011-1

Cited by 5 publications

(10 citation statements)

References 22 publications

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“…The use of EUS in the work-up of children with pancreatobiliary pathology may limit exposure to risk of adverse events from ERCP [152]. MRCP and ERCP may be used—the first to document the communication of the cyst with the main pancreatic duct [40, 41, 45, 49, 68, 71, 97, 128, 138, 145, 154, 156, 247, 253, 259, 261] and, the latter, for treating the disease.…”

Section: Methodsmentioning

confidence: 99%

“…Abscess or intra-abdominal sepsis occurs in 7–25% of patients with pancreatic injuries; CT-scan or MRI should be performed for diagnosis and to guide treatment [40, 156].…”

Section: Methodsmentioning

confidence: 99%

“…Preoperative cross-sectional imaging and pancreatogram during ERCP are essential. The ERCP, when feasible, is the first step to treat persisting fistulas [11, 40, 41, 48, 49, 61, 71, 156, 233, 262].…”

Section: Methodsmentioning

confidence: 99%

“…The incidence of post-traumatic pancreatitis is 17%. Patients with abdominal pain and hyperamylasemia should undergo contrast-enhanced CT-scan for diagnosis wherever possible [40, 156].…”

Section: Methodsmentioning

confidence: 99%

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Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

et al. 2019

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Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.

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Section: Methodsmentioning

confidence: 99%

“…Abscess or intra-abdominal sepsis occurs in 7–25% of patients with pancreatic injuries; CT-scan or MRI should be performed for diagnosis and to guide treatment [40, 156].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The incidence of post-traumatic pancreatitis is 17%. Patients with abdominal pain and hyperamylasemia should undergo contrast-enhanced CT-scan for diagnosis wherever possible [40, 156].…”

Section: Methodsmentioning

confidence: 99%

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Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

et al. 2019

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“…En la presente investigación, la prevalencia de lesiones abdominales asociadas a TP, TD o TPD ronda entre el 0.8% y un máximo del 8%. Hay una clara relación anatómica entre el páncreas y el duodeno, que predispone a lesión orgánica múltiple implicando a estos dos órganos, y en la mayoría de las ocasiones a más órganos intraabdominales [16][17][18][19][20] .…”

Section: Discussionunclassified

Pronóstico de mortalidad y evolución en trauma pancreatoduodenal en pacientes con herida por proyectil de arma de fuego

Cantú-Alejo¹,

Cantú-Kawas²,

Guevara-Charles³

et al. 2020

CIRU

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Antecedentes: Las heridas por proyectil de arma de fuego constituyen un problema de salud pública en el mundo. Como ejemplo mencionamos que este tipo de lesiones son la primera causa de muerte en el grupo de edad de 1 a 19 años en los EE.UU., al igual que en México. Objetivo: Análisis de los factores pronósticos de mortalidad y evaluación de la evolución en pacientes con TPD por HPPAF abdominal. Método: Estudio retrospectivo, observacional y descriptivo, realizado con 49 expedientes clínicos de pacientes que fueron admitidos en el departamento de cirugía del Hospital Universitario José Eleuterio González entre los años 2011 y 2015, cuyo diagnostico fue herida por proyectil de arma de fuego con trauma pancreático (TP), duodenal (TD) o pancreatoduodenal (TPD). Resultados: Durante un periodo de recolección de 5 años se obtuvieron 49 expedientes clínicos aplicables al estudio según los criterios de inclusión, de los cuales 36 pacientes (73%) sufrieron únicamente TD, 37 (75%) TP y 24 (49%) TPD. Se obtuvieron diferencias significativas para la mortalidad asociada a TD y TPD, pero no para TP. El órgano más afectado como lesión asociada a un TPD fue el hígado, seguido de las estructuras torácicas y el estómago. El factor de riesgo para mortalidad más significativo fue una estancia prolongada en la unidad de cuidados intensivos. Conclusiones: Los datos conseguidos concuerdan con los consultados, otorgando nueva estadística reproducible para futuros estudios respecto a la violencia creciente en nuestro país y alrededor del mundo.

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Management of pancreatic trauma-a single center experience

et al. 2022

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Background: Traumatic injury to the pancreas is rare and frequently overlooked. High index of suspicion is required in diagnosing pancreatic injury and management is challenging even with experienced trauma surgeons. The aim of this study was to report our experience in the management of pancreatic injuries.Methods: We analyzed 39 patients with pancreatic injury managed in our center from January 2016- December 2021. Data regarding patients’ demographics, mode of injury, American association for the surgery of trauma-organ injury scale (AAST-OIS) grade of pancreatic injury, associated injuries, management, morbidity and mortality were collected for analysis.Results: The study included 39 patients who presented with blunt injury abdomen (AAST-OIS grading: grade 2 (n=6), grade 3 (n=29), grade 4 (n=4)) with mean age 28.9 years. Associated injuries were present in 41% of patients (n=16). Thirteen patients had non-operative management-5 of them were managed conservatively without any intervention; 8 of them had non-surgical intervention in the form of Percutaneous Drainage or Endoscopic Retrograde Cholangio Pancreatography with Pancreatic duct stent for peri-pancreatic collection or ductal injury. But the rate of readmission for recurrent pancreatitis and reintervention for peri-pancreatic collection was 46% and 38% respectively in these patients. Twenty-six patients underwent surgery-distal pancreato splenectomy, laparotomy and external drainage, Roux-en Y pancreaticojejunostomy.Conclusions: Management of high-grade pancreatic injuries needs technical expertise. Early diagnosis and appropriate surgical management in high-grade pancreatic injuries carries favorable outcomes. Delayed presentation with sepsis is associated with high mortality.

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Penetrating Pancreatic Injury

Cited by 5 publications

References 22 publications

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Pronóstico de mortalidad y evolución en trauma pancreatoduodenal en pacientes con herida por proyectil de arma de fuego

Management of pancreatic trauma-a single center experience

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