[Pancreatic injuries: analysis of 20 cases]

The aim of this study is to stage pancreatic injury and to assess the appropriate surgical approach. Trauma leading to pancreatic injury, factors responsible for the mortality and complication rates are evaluated and compared with the literature.

Records of 20 patients with pancreatic injuries treated at the Emergency Surgical Unit of Research Hospital between January 1997 to October 2001 were retrospectively evaluated.

In this series 20 per cent of the mortality occurred within the first 48 hours. The factor responsible for the mortality in these patients was major bleeding; related to major vascular, hepatic, splenic, renal or thoracic injuries. Late mortality was seen in 3 patients (15 per cent) due to sepsis, respiratory insufficiency or ARDS. ln the literature mortality rate is between 5 to 30 per cent and morbidity rate is 30 to 64 per cent. In this series, these percentages were 35 per cent and 43 per cent respectively.

The surgical therapy should be tailored up to the presence of ductal injury and the extent and anatomical localization of the injured segment. In principle the control of bleeding and contamination, and application of the appropriate surgical treatment can lower the morbidity and mortality. Key words: Abdominal trauma, pancreatic injury, pancreatic drainage