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Management and Clinical Outcomes of Pancreaticoduodenal Injuries at a Tertiary Care Centre in Southern India

Lokeshwaran Ayyasamy1, Senthilkumaran Govindaraj Raman1, Sudhagar Rengasamy1

  • 1Department of Surgical Gastroenterology & GI Oncology, Thanjavur Medical College, Thanjavur, IND.

Cureus
|June 13, 2025
PubMed

Insights

Diagnosing pancreaticoduodenal injuries requires high suspicion due to their location. Delayed treatment of these blunt trauma injuries significantly increases patient morbidity and mortality.

Area of Science:

  • Trauma Surgery
  • Surgical Gastroenterology
  • Abdominal Trauma

Background:

  • Pancreaticoduodenal injuries present diagnostic challenges due to their retroperitoneal location.
  • Early diagnosis and prompt management are crucial to mitigate morbidity and mortality.
  • Delayed presentation of these injuries is associated with increased adverse outcomes.

Purpose of the Study:

  • To analyze the demographics, presentation, grading, management, morbidity, and mortality of pancreaticoduodenal injuries.
  • To identify factors influencing outcomes in patients with pancreaticoduodenal injuries.

Main Methods:

  • An ambispective study involving 31 patients over a five-year period (October 2019 - October 2024).
  • Data collected included patient demographics, injury mechanism, clinical status on arrival, injury grade, treatment received, and postoperative outcomes.

Main Results:

  • The majority of patients were male (93.5%) and sustained blunt trauma (83.8%).
  • Postoperative morbidity was 32%, and mortality was approximately 7%.
  • Delayed admission (>48 hours) was significantly associated with increased postoperative morbidity (p = 0.029).
  • Nonoperative management was successful in five high-grade (Grade 4) injuries; one Grade 5 injury required a Whipple procedure.

Conclusions:

  • A high index of suspicion is essential for diagnosing pancreaticoduodenal injuries.
  • Delayed diagnosis and treatment adversely affect patient morbidity and mortality.
  • Conservative management with serial monitoring may be considered for selected high-grade injuries in specialized centers.
Abstract

Keywords:
blunt traumaduodenal injuriesmorbiditymortalitypancreatic injuries

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