The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma

Wolf, Andrea; Bernhardt, J.; Patrzyk, Maciej; Heidecke, Claus Dieter

doi:10.1007/s00464-003-9276-5

Cited by 76 publications

(62 citation statements)

References 23 publications

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“…The ERCP scores not only the diagnosis but it also can rule out pancreatic injury. It is possible to spare patients an operation by placing a stent during the same session and carry out definitive and interventional treatment [13]. Its application is limited, especially in the acute trauma situation, as it can only be performed in stable patients and requires an experienced endoscopist [7,14,15].…”

Section: Discussionmentioning

confidence: 99%

Blunt Abdominal Injury with Transection of Pancreatic Neck Detected Early by Abdominal Computed Tomography: A Case Report and Review of the Literature

Wang¹,

Hsu²,

Huang³

et al. 2006

Visc Med

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Blunt abdominal trauma resulting in injury to the pancreas is relatively rare, but carries high morbidity and mortality rates, especially when diagnosis is delayed or inappropriate surgery is attempted. Early recognition of disruption of the main pancreatic duct is important because such disruption is the principal cause of delayed complication. Abdominal CT gives the best opportunity for an immediate diagnosis. We herein report a case of transection of pancreatic neck from blunt abdominal trauma that was detected early by abdominal CT and managed by immediate distal pancreatectomy.

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Section: Discussionmentioning

confidence: 99%

Blunt Abdominal Injury with Transection of Pancreatic Neck Detected Early by Abdominal Computed Tomography: A Case Report and Review of the Literature

Wang¹,

Hsu²,

Huang³

et al. 2006

Visc Med

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“…Uncommonly used as a first-line test, ERCP becomes useful in patients with delayed presentation (with the late onset of pain or post-traumatic pseudocysts) [30,[34][35][36]. Houben et al [37] reported on 15 pediatric trauma patients with pancreatic injuries all of whom but two presented with a delay.…”

Section: Diagnosismentioning

confidence: 99%

Nonoperative Management of Pancreato-Duodenal Injuries

Spaniolas

Velmahos

2007

Eur J Trauma Emerg Surg

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Following injuries to the pancreas and duodenum (PDI) patients often present in extremis and undergo immediate laparotomy for hemodynamic instability and peritoneal signs. Nonoperative management (NOM) may be offered in selected patients with lowgrade injuries. Precise mapping of the injury, most commonly by computed tomography, is a prerequisite for NOM because clinical symptomatology can be variable and misleading. Additionally, delaying the treatment of PDI that should be corrected surgically may lead to significant complications. Therefore, NOM of PDI presents unique challenges, and the decision-making is not as straightforward as it is with NOM of other solid abdominal organs. Essentially, only duodenal hematomas without fullthickness wall perforation (Grade I and selected II) and pancreatic trauma without major duct involvement (Grade I and selected II) could be offered NOM. In these cases, the reported success rates vary from 74 to 95%. There are also a few severe pancreatic injuries that can be managed by stents with adequate reconstitution of the major pancreatic duct integrity and resolution of symptoms and without the need for operative management. Intensive monitoring and follow-up by clinical examination and repeat CT imaging is essential in these patients, as the risk of complications, and particularly a pseudocyst is high.

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“…Surgery may be totally avoided [4,22,23]. Because of the rarity of posttraumatic duct disruption, the series are small.…”

Section: Endoscopic Interventionsmentioning

confidence: 99%

Treatment of Pancreatic Fistulas

Halttunen

Kylänpää

2007

Eur J Trauma Emerg Surg

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The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma

Cited by 76 publications

References 23 publications

Blunt Abdominal Injury with Transection of Pancreatic Neck Detected Early by Abdominal Computed Tomography: A Case Report and Review of the Literature

Blunt Abdominal Injury with Transection of Pancreatic Neck Detected Early by Abdominal Computed Tomography: A Case Report and Review of the Literature

Nonoperative Management of Pancreato-Duodenal Injuries

Treatment of Pancreatic Fistulas

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