Pancreatic trauma

Pancreatic injuries are relatively uncommon and usually accompany injuries to major vessels or other gastrointestinal organs. Because it is these associated injuries that are responsible for the early morbidity and mortality, control of hemorrhage and bacterial contamination takes initial priority over the pancreatic injury. The management of specific pancreatic injury depends on the status of the main pancreatic duct, the degree of parenchymal damage, and the anatomic location of the injury. Complete visualization of the gland and accurate determination of the duct status are key intraoperative maneuvers. Failure to recognize significant pancreatic duct and parenchymal injury is the major cause of postoperative morbidity. The vast majority of pancreatic injuries can be managed by simple drainage with or without debridement or suture. However, the occasional major transection or pancreatic duct injury warrants rigorous efforts at determining the status of the major ducts.