Pancreatic trauma

The early diagnosis of pancreatic injuries depends on a high degree of clinical suspicion. During laparotomy, exploration of the pancreas and duodenum for suspected injury should be thorough and orderly. In managing these injuries, one should select the simplest procedure that will re-establish the integrity of the upper gastrointestinal tract and control the free escape of pancreatic juices into the surrounding tissue. In general, resection of the distal portion of the body and tail of the pancreas for severe injuries in that area and duodenal diverticularization for injuries involving the pancreatic head are the procedures of choice for preservation of functioning pancreatic tissue.