Pancreatic trauma is no longer a rare injury, mostly as a result of the increase in the incidence of high velocity automobile accidents and other acts of violence. The management of pancreatic trauma has become an increasingly frequent subject in the medical literature. The preoperative diagnosis of pancreatic injury is very difficult when there is no indic ation for surgical exploration of the abdomen for other associated injuries. The diagnostic aids such as serum amylase determination, peritoneal aspiration, radiography, ERCP and CT scan have been used with variable success.
This is a review of diagnosis and treatment principles based on 10 year experience at the Wallace Memmorial Baptist Hospital with 15 patients who required laparotomy for pancreatic injury except cases of pseudocyst and traumatic pancreatitis.
The results were as follows;
1) The sex distribution was 14 males and 1 female, with ratio of 14:1, and the age distribution indicated predominant incidence between 2nd and 4th decades(60%).
2) 14 cases were by blunt trauma and 1 wasby stab injury.
3) The sites of injury were 5 in head, 5 in body and 5 in tail region.
4) Associated injuries were present in 13 cases (86.7%). Mean number of associated organ injury was 3.
5) The preoperative serum amylase determination was helpful in 7 out of 12 cases (58%).
6) The operative managements were simple drainage in 3 cases, suture and drainage in 4 cases, distal pancreatectomy in 5 cases, pancreaticojejunostomy in 2 cases and pancreaticoduodenectomy in 1 case.
7) The postoperative complications were 1 pseudocyst, 2 pancreatitis, 2 intra-abdominal abscess and 3 septic shocks.
8) 4 out of 15 cases expired postoperatively (26.7%) caused by overwhelming sepsis, renal failure and acute myocardial infarction.
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