[Computed tomography in the diagnosis of posttraumatic pancreatic lesions]

CT is currently the most accurate technique to study pancreatic parenchyma traumas. We examined six patients with pancreatic injuries due to a car crash in five cases and to a gunshot in one using a 3rd generation CT unit with 8- and 4-mm slices in the upper abdomen and pancreas, respectively; a contrast agent was administered i.v. US was performed with a 3.5 MHz sectorial probe. The correct diagnosis was made by CT alone in five cases, while US had already suspected isthmus trauma in one case and CT confirmed it. One critical patient was submitted to emergency laparotomy without preoperative CT or US, but CT was used for postoperative follow-up. CT showed partial isthmus laceration in one of three patients submitted to conservative treatment and a body-tail laceration in the others. CT showed complete isthmus laceration in three surgical patients and a tail injury in the gunshot patient; the third patient had already undergone duodenocephalopancreatectomy and was therefore only followed-up. In our experience, CT is the most valuable tool to study pancreatic traumas because it is a fast and noninvasive method and shows pancreatic parenchyma better than US. Moreover, CT is useful also to monitor the possible complications of pancreatic trauma and to follow-up surgical patients.