[Stomach, duodenal and pancreatic injuries: diagnosis, surgical procedure]

Whereas ruptures of the spleen and liver are comparatively frequent, traumas to the pancreas, stomach and duodenum belong to the rarities. Thus, observed in our own patient material from 1982 to 1988, out of 218 surgically treated patients with a blunt abdominal trauma, we found only 1 duodenal rupture, 1 rupture of the stomach and 5 injuries to the pancreas. Diagnostics and therapy however can raise considerable problems. The indication for surgery is obtained clinically, the peritoneal lavage being the most important diagnostic procedure. Whereas treatment of a gastric rupture is not a problem, treatment of a duodenal rupture depends on the type of rupture. Lesions to the pancreas carry a bad prognosis depending on the degree of seriousness. Mortality is high ranging between 10 and 20%. Therapy depends on the degree of seriousness and has to be limited to a drainage operation in the individual case.