Pancreatic injury, although infrequently encountered, merits consideration in every patients having abdominal trauma. The correct preoperative diagnosis is rather difficult and seldom made until various diagnostic methods were used especially in cases of blunt trauma. Even the operative diagnosis is difficult because of the anatomical location and the difficulty of thorough exploration of the ductal system. Overlooked ductal injury may bring disaster.
This report has reviewed our experience with 45 cases of pancreatic injury at Capital Armed Forces General Hospital during 7 years from January 1977 to December 1983.
The followings are the result;
1) According to the cause of the injury, these cases were divided into two groups, blunt trauma in 26 cases(57.8%) and penetrating trauma in 19 cases(42.2%).
2) The site of injury was body of pancreas occuring in 18 cases, tail in 15 cases and head in 12 cases. The order of frequency was tail, body, and head in penetrating trauma and body, head, and tail in blunt trauma.
3) The time interval between time of accident and time of operation was within 6 hours in all cases of penetrating trauma and 57.8% of blunt trauma.
4) The order of associated organ injury was stomach, spleen, liver and colon in general, and spleen, liver, stomach and duodenum in blunt trauma, and stomach, colon, liver and spleen in penetrating trauma. There were about 3 organs of associated injury in penetrating trauma and about 1 organ in blunt trauma.
5) The most common treatment method was simple drainage in head injury and distal pancreatectomy in body and tail injury.
6) The order of complication was wound infection, pancreatic fistula, sepsis, and intraa-bdominal abscess, and the mortality was 21% in penetrating trauma and 15% in blunt trauma.
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