CT diagnosis of blunt pancreatic trauma: importance of detecting fluid between the pancreas and the splenic vein.
OBJECTIVE
The purpose of this study was to determine the value of detecting fluid between the splenic vein and the pancreas on CT scans in the diagnosis of pancreatic injury after blunt abdominal trauma.


METHODS
We retrospectively reviewed the abdominal CT scans of 10 patients with surgical- or autopsy-proved pancreatic injury after blunt abdominal trauma. The finding of fluid interdigitating between the pancreas and the splenic vein was then studied along with the reported CT features of pancreatic injury. These included intraperitoneal fluid, fluid in the lesser sac, extraperitoneal fluid, pancreatic edema or hematoma, and thickening of the anterior renal fascia.


RESULTS
The CT scans of all 10 patients reviewed showed abnormalities suggesting pancreatic injury. Only 40% of patients showed all of the findings reported in the literature. Fluid interdigitating between the splenic vein and the pancreatic parenchyma was seen on CT scans in 90%.


CONCLUSIONS
Our experience suggests that fluid between the splenic vein and the pancreas is a helpful CT finding for the diagnosis of pancreatic injury after blunt abdominal trauma. This finding was easy to recognize and in the proper clinical setting directs attention to additional subtle findings of pancreatic injury.
Lane
M J
MJ
Department of Radiology, Stanford University Medical Center, CA 94305.
Mindelzun
R E
RE
Sandhu
J S
JS
McCormick
V D
VD
Jeffrey
R B
RB
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging / Q000293:injuries*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013162:Splenic Vein / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000453:epidemiology