Management of pancreatic injuries

Pancreatic injuries from penetrating trauma are usually diagnosed early owing to the obvious indications for early abdominal exploration. Isolated injuries to the pancreas from blunt abdominal trauma are frequently diagnosed late since a period of time is required for the development of clinical signs of peritonitis or pancreatitis. A significant elevation of serum amylase level was found in all cases of delayed operation in this study. Distal pancreatectomy concomitant with splenectomy was the most frequent operation performed for injuries to the body and tail of the pancreas. Splenic preserving distal pancreatectomy was also performed in 3 cases. Adequate external drainage was required in all forms of pancreatic injuries. Although, the morbidity rate was 41 per cent, almost all recovered after a period of conservative treatment. Two patients died from intraabdominal sepsis and multi-system organ failure. The mortality in pancreatic trauma was related to associated injuries rather than to pancreatic injury alone.