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Pancreatic injury.

W V Hagan, L F Urdaneta, S E Stephenson

    Southern Medical Journal
    |August 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Pancreatic trauma, often caused by gunshot wounds, has a high complication rate. Roux-en-Y pancreaticojejunostomy is recommended for severe pancreatic head injuries, showing better outcomes than resection.

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    Area of Science:

    • Trauma Surgery
    • Surgical Gastroenterology
    • Abdominal Trauma Management

    Background:

    • This study reviews 50 cases of pancreatic trauma from 1967-1977.
    • Pancreatic trauma presents significant management challenges due to high complication rates and associated injuries.

    Observation:

    • Gunshot wounds accounted for the majority (40 cases) of pancreatic trauma.
    • Associated injuries, particularly major vascular injuries (30%), significantly increased mortality (50%).
    • Complications directly attributable to pancreatic injury occurred in 27% of patients.

    Findings:

    • Drainage alone was the most common treatment (36 patients).
    • Pancreaticoduodenectomy for severe head injuries resulted in high mortality early in the series.
    • A Puestow type Roux-en-Y pancreaticojejunostomy demonstrated improved outcomes for severe pancreatic head injuries, with one death and no complications in five cases.

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    Implications:

    • Sump tube drainage is advocated for most pancreatic injuries.
    • Roux-en-Y pancreaticojejunostomy is the preferred method for severe pancreatic head injuries over resection.
    • Improved surgical techniques can reduce mortality and morbidity associated with pancreatic trauma.