[Computed tomography of the abdomen in 8 cases of pancreatic trauma]

Computed tomography (CT) is an accurate method for detecting pancreatic trauma. There are two pitfalls to its use: the indication of CT and the risk of misinterpretation. The purpose of this study was to evaluate these 2 difficulties. We report our experience and results obtained in 8 patients with pancreatic trauma (7 closed, 1 open). Peritoneal lavage demonstrated an increased amylase level in the fluid in 2 of our patients. Computed tomography was performed as an emergency diagnostic test for 2 patients and secondarily in 6 patients. In 5 patients, the pancreatic injury was considered to be deep with suspicion of a major pancreatic duct lesion and in 3 patients, the lesion was superficial. Six patients had operative confirmation of the CT results. Pancreatic injuries were classified according to Hervé and Arrighis. Four were grade III, 1 grade II, 1 grade I, while CT showed 5 deep injuries and 1 superficial injury in these patients. Two patients with CT signs of superficial injury were not operated. When there is a clinical suspicion and/or a high amylase level in serum, urine or fluid collected from peritoneal lavage, CT must be carried out as part of in the overall strategy of management of isolated pancreatic trauma. We believe that CT is a valuable tool to evaluate the extent of the injury to the pancreatic parenchyma.