Management strategies in isolated pancreatic trauma.
OBJECTIVE
In the absence of damage to other organs, pancreatic injury is rare. We have reviewed our experience with isolated pancreatic injury.


METHODS
Patients treated for isolated pancreatic trauma at our unit were identified prospectively and then retrospectively entered onto a database. The mode of presentation, mechanism of injury and management strategies were reviewed.


RESULTS
Seven male and four female patients, median age 30 years (range 13-51 years) were treated. All suffered blunt abdominal trauma with different mechanisms of injury, each being characterised by a direct blow to the central abdomen. In two patients, somatostatin analogue treatment used as primary treatment resulted in early resolution of symptoms and signs. Six patients underwent surgery at various stages post-injury. At a median follow-up of 58 months (range 22-106 months), eight patients are asymptomatic, two patients have chronic pain following distal pancreatectomy and one patient has occasional discomfort.


CONCLUSIONS
Confirmation of the mechanism of trauma and suspicion of pancreatic injury are essential for early diagnosis and appropriate management. Early contrast computed tomography examination is vital in the recognition of these injuries. Somatostatin analogue therapy may have an important role in the treatment regimen, especially when patients present early after sustaining a pancreatic injury. Only selected patients require open surgery.
Lochan
R
R
Department of Surgery, Hepato-Pancreato-Biliary Surgery Unit, Freeman Hospital, Newcastle upon Tyne, UK.
Sen
G
G
Barrett
A M
AM
Scott
J
J
Charnley
R M
RM
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010179:Pancreas / Q000293:injuries*; D010180:Pancreatectomy; D011446:Prospective Studies; D012189:Retrospective Studies; D013004:Somatostatin / Q000627:therapeutic use; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000628:therapy*
D005765:Gastrointestinal Agents; D013004:Somatostatin; D015282:Octreotide