Pancreatic Trauma (Blunt)


Background
  1. Injury to pancreas from blunt abdominal trauma
  2. Pancreas is infrequently injured
      • Relatively protected
        • Located in the retroperitoneal space
  3. Diagnosis can be very difficult
  4. Risk factors (possible)
  5. Morbidity & mortality
  6. Prognosis

Pathophysiology

  1. Anatomy:
  2. Mechanism of injury
  3. Injury Grades (AAST scale)

Diagnostics:

  1. History
  2. Physical exam
  3. Diagnostic testing
  4. Diagnostic imaging:

Differential Diagnosis

  1. Blunt intestinal trauma
  2. Blunt splenic trauma
  3. Blunt hepatic trauma
  4. Kidney trauma
  5. Pelvic fracture
  6. Abdominal wall injury
  7. Gastric rupture

Treatment

  1. ATLS as usual
  2. May require a lot of fluid resuscitation
  3. FAST scan / DPL
  4. NG tube / foley PRN
  5. Serial exams
  6. Further management
  7. Patients may have delayed presentation
  8. Surgical treatment
  9. Complications