Pancreatic injuries. Diagnosis, treatment

Pancreatic injuries are not as common as other intraabdominal injuries, but require proper treatment to prevent secondary life-threatening complications. Early recognition of pancreatic injury, identification of major ductal disruptions, and appropriate operative interventions to control pancreatic secretions and to establish external drainage are required for proper management. Pancreatic injuries have a low priority in the management of multiorgan trauma, and repair should not be undertaken until hemorrhage and gastrointestinal contamination are controlled. Any pancreatic injury can be treated temporarily by adequate external drainage alone, thereby creating a controlled fistula in the patient deemed too unstable to undergo primary operative repair at the time of initial laparotomy.