Factors affecting outcome in pancreatic trauma

Area of Science:

• Trauma Surgery
• Surgical Gastroenterology
• Abdominal Trauma

Background:

• Pancreatic trauma is associated with significant mortality (approx. 20%) and morbidity (approx. 33%).
• Unresolved challenges in managing pancreatic trauma necessitate further investigation.
• Associated intra-abdominal injuries complicate patient outcomes.

Purpose of the Study:

• To review a recent patient series to identify persistent problems in pancreatic trauma management.
• To analyze factors contributing to morbidity and mortality in pancreatic trauma patients.

Main Methods:

• Retrospective review of 44 consecutive patients treated operatively for pancreatic trauma over a 7-year period.
• Evaluation of patient outcomes, including mortality, fistulas, and abscesses.
• Analysis of associated injuries, particularly colon and duodenal trauma.

Main Results:

• Six deaths and 12 cases of fistulas/abscesses occurred among 44 evaluated patients.
• Colon injuries were linked to higher rates of intra-abdominal abscesses and fistulas, and were present in 4 of 6 fatal cases.
• Duodenal injuries also contributed to high morbidity and mortality.
• All six deaths occurred in patients who experienced shock before operation.
• Patients sustained an average of 2.1 associated intra-abdominal organ injuries.

Conclusions:

• Colon injury is a critical factor driving morbidity and mortality in pancreatic trauma.
• Despite advances, duodenal injuries remain associated with high complication rates.
• Hemorrhagic shock and associated organ injuries are directly related to poor outcomes in pancreatic trauma.