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Pancreatic trauma: a ten-year multi-institutional experience
R Akhrass1, M B Yaffe, C P Brandt
1Department of Surgery, Case Western Reserve University, Cleveland, Ohio, USA.
The American Surgeon
|July 1, 1997
Summary
Traumatic pancreatic injury is rare, often caused by penetrating trauma. Management and outcomes show significant morbidity and mortality, frequently linked to associated injuries.
Area of Science:
- Trauma Surgery
- Surgical Gastroenterology
- Abdominal Trauma
Background:
- Traumatic pancreatic injury is an uncommon but serious condition.
- Understanding its incidence, management, and outcomes is crucial for improving patient care.
Purpose of the Study:
- To determine the incidence, management strategies, and outcomes of traumatic pancreatic injuries.
- To analyze the relationship between injury grade, mechanism, and patient outcomes.
Main Methods:
- Retrospective review of 72 patients with pancreatic injury over 10 years at two Level I trauma centers.
- Comparison of injury characteristics and management using Chi-square or Fisher's exact tests.
- Analysis of diagnostic accuracy between computed tomography and intraoperative findings.
Main Results:
- Pancreatic injury occurred in 0.4% of trauma admissions, more common with penetrating trauma (1.1%) than blunt (0.2%).
- Distal pancreatectomy was the most common operative procedure (32%). Mortality was 16.6%, with higher Injury Severity Scores and transfusion needs in non-survivors.
- Morbidity occurred in 42% of patients, including pancreatic fistula (11%), pancreatitis (7%), and pseudocyst (3%).
Conclusions:
- Traumatic pancreatic injury is infrequent, predominantly associated with penetrating mechanisms.
- Computed tomography may underestimate injury severity compared to surgical exploration.
- Drainage of low-grade injuries might be unnecessary, and associated injuries significantly impact morbidity and mortality.