title: Management of pancreatic injuries after blunt abdominal trauma. Experience at a single institution.
abstract: BACKGROUND
  Pancreatic injuries after blunt abdominal trauma could result in significant morbidity, and even mortality if missed.
  
  
  OBJECTIVE
  Our aim was to review our institution's experience with blunt pancreatic trauma.
  
  
  METHODS
  Our study included all cases of blunt traumatic pancreatic injuries.
  
  
  METHODS
  Sixteen patients (median age 41 years; range: 18-60 years) were treated for blunt pancreatic trauma from December 2002 to June 2008.
  
  
  METHODS
  Pancreatic injuries were graded according to the definition of the American Association for the Surgery of Trauma (AAST).
  
  
  RESULTS
  CT scans were performed on 10 (62.5%) patients, with the remaining 6 (37.5%) sent to the operating theatre immediately due to their injuries. Of the 12 (75.0%) patients who underwent exploratory laparotomy, 2 (12.5%) had a distal pancreatectomy (AAST grade III), 1 (6.3%) underwent a Whipple procedure (AAST grade IV) while another 2 (12.5%) were too hemodynamically unstable for any definitive surgery (AAST grade IV and V); the remaining 7 (43.8%) pancreatic injuries were managed conservatively. Four (25.0%) patients had their injuries managed non-operatively. Some of the associated complications included intra-abdominal collection (n=2, 12.5%) and chest infection (n=2, 12.5%).
  
  
  CONCLUSIONS
  Blunt pancreatic trauma continues to pose significant diagnostic and therapeutic challenges. In view of the numerous associated injuries, priority must be given to stabilizing the patient before any definitive management of the pancreatic injuries is carried out. Mortality in these patients is usually a result of the magnitude of their associated injuries.
authors.affiliation: TTSH-NNI Trauma Centre, Tan Tock Seng Hospital, Singapore, Singapore. kerkan@gmail.com
authors.forename: Ker Kan
authors.initials: KK
authors.lastname: Tan
authors.forename: Diana Xinhui
authors.initials: DX
authors.lastname: Chan
authors.forename: Appasamy
authors.initials: A
authors.lastname: Vijayan
authors.forename: Ming Terk
authors.initials: MT
authors.lastname: Chiu
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries*; D012107:Research Design; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult