title: Current management of pancreatic trauma.
abstract: BACKGROUND
  Although pancreatic trauma is uncommon, it poses a diagnostic and therapeutic challenge. Any delay in diagnosis raises morbidity and mortality. This study highlights the current management and outcome in patients of pancreatic trauma at a single tertiary care center.
  
  
  METHODS
  This is a retrospective analysis of prospectively collected data of 24 patients diagnosed to have pancreatic trauma. Collected data was analyzed for age, gender, mechanism of injury, hemodynamic status at presentation, initial serum amylase levels, CECT abdomen findings, AAST-OIS grade of pancreatic injury, injury to other organs, management, complications and outcome.
  
  
  RESULTS
  The mean age of these 24 patients was 25 years; 19 were male and 5 females. The mechanisms of pancreatic trauma included blunt abdominal trauma in 21 (87.5%) cases and penetrating injury in 3 (12.5%). Seven (29.16%) patients were managed by non-operative management and 17 (70.83%) underwent surgery. Complications were more frequent in the operative group as compared to the non-operative group. Neither endocrine deficiency nor any mortality was noted in the non-operative management group; while there were 2 cases of endocrine deficiency and 3 mortalities in the operative group.
  
  
  CONCLUSIONS
  Pancreatic trauma is more common in young male patients and more commonly inflicted by motor vehicles accidents. Low grade blunt pancreatic injury in hemodynamically stable patients and selected patients with high grade blunt pancreatic injury can be managed successfully by non-operative management with no increase in morbidity or mortality and most patients with high grade blunt pancreatic injury and those having penetrating injuries need surgical intervention.
authors.affiliation: Departments of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. kamanlil@yahoo.com
authors.forename: Lileswar
authors.initials: L
authors.lastname: Kaman
authors.forename: Javid
authors.initials: J
authors.lastname: Iqbal
authors.forename: Mahander
authors.initials: M
authors.lastname: Pall
authors.forename: Ishwar
authors.initials: I
authors.lastname: Bhukal
authors.forename: Arunanshu
authors.initials: A
authors.lastname: Behera
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Singh
authors.forename: Rajinder
authors.initials: R
authors.lastname: Singh
mesh_terms: D000328:Adult; D001658:Biliary Fistula / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy; D008297:Male; D010179:Pancreas / Q000293:injuries* / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology / Q000628:therapy; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology; D012141:Respiratory Tract Infections / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery* / Q000628:therapy; D014950:Wounds, Penetrating / Q000150:complications / Q000601:surgery* / Q000628:therapy