[Blunt isolated pancreatic trauma. Diagnostic problems--a clinical and radiological challenge].
BACKGROUND
Blunt isolated pancreas trauma is rare, but it is a very serious condition. Diagnosis and treatment are often delayed, which considerably increases morbidity. The delay is caused by uncharacteristic symptomatology and the application of paraclinical and radiological diagnostic methods of low initial sensitivity and specificity. The aim of this study was to describe the diagnostic difficulties and the applicability of the various radiological modalities.


METHODS
During the period 1995-2000, three patients with blunt isolated pancreas trauma were treated, and the case reports were examined retrospectively.


RESULTS
All three showed classical mechanisms of injury, and a characteristic delay in diagnosis and treatment of 24 to 48 hours was seen.


CONCLUSIONS
The frequent delay in diagnosis and subsequent treatment of the blunt pancreas trauma requires a more optimal strategy for handling such traumas. We recommend the following diagnostic algorithm: Repeated measurements of serum amylase initially. Image diagnostics with a dynamic spiral CT-scan with both oral and intravenous contrast. The CT scan is to be repeated or supplemented by MRCP on continued suspicion of pancreas injury, even when the initial CT scan shows normal findings.
Wittendorff
Hans-Erik
HE
Kirurgisk gastroenterologisk afdeling, Amtssygehuset i Herlev. Wittendorff@dadlnet.dk
Fallentin
Eva M
EM
Hansen
Mark Berner
MB
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery
D015415:Biomarkers
Stumpe isolerede pancreastraumer. Diagnostiske problemer--en klinisk og radiologisk udfordring.