Pancreatic trauma--12-year experience from a tertiary center.
Pancreatic trauma is rare and often missed during initial assessment of patients with abdominal trauma. This study reviews our experience of managing pancreatic trauma at a tertiary referral center and discusses the diagnostic and therapeutic challenges.


METHODS
A retrospective study of our prospectively maintained hepato-pancreatico-biliary database for 12 years preceding December 2007.


RESULTS
Twenty-eight patients (23 males, 10 children) with a median age of 11.5 years (range, 6-16 years) in children and 27.5 years (range, 17-54 years) in adults were identified. Nineteen of the 28 had pancreatic duct injury of which 15 were missed on initial evaluation and referred after conservative management (n = 9) or laparotomy (n = 6). Twenty-one patients developed complications including abdominal collections (n = 10), pancreatic fistulae (n = 9), and pseudocysts (n = 2). There were 2 deaths (7%), both of which were associated with multiple intra-abdominal injuries. At a median follow-up of 7.5 months (range, 3-44 months), 19 of 23 patients were asymptomatic and had been discharged from follow-up.


CONCLUSIONS
Pancreatic trauma in the United Kingdom is mainly the result of blunt trauma and most commonly affects young males. The presence of pancreatic duct disruption accounts for most of the complications, and in the absence of associated injuries, mortality is rare.
Thomas
Harun
H
Institute of Liver Studies, Kings College School of Medicine at Denmark Hill, Camberwell, Kings College Hospital, London, United Kingdom.
Madanur
Mansoor
M
Bartlett
Adam
A
Marangoni
Gabriele
G
Heaton
Nigel
N
Rela
Mohamed
M
D000293:Adolescent; D000328:Adult; D000681:Amylases / Q000097:blood; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries*; D010185:Pancreatic Fistula / Q000209:etiology; D010192:Pancreatic Pseudocyst / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000681:Amylases