Since the first pancreatic injury was reported by Travers in England in 1827, pancreatic injury remains a major source of morbidity and mortality.
In spite of the much advances in diagnostic tools, operative method and perioperative care, morbidity and mortality rates of the traumatic pancreatic injuries remain high. Those are due to its retroperitoneal location, uncommon happening and
frequent
associated injuries of adjacent organs and vessels.
A retrospective analysis of 50 patients who sustained traumatic pancreatic injuries diagnosed by operation during the about 9 years-period from August, 1984 to February, 1993 at the Department of Surgery, Dul Ji General Hospital was conducted and
the
results are as follows.
1) The age distribution showed the highest incidence in the 3rd decade(38%) and the male to female ratio was about 6:1.
2) Almost all cases(94%) were injured by blunt trauma and the most common cause of blunt trauma was traffic accident.
3) No significant difference in mortality of time interval between injury and operation. But, complication rate was increased in over than 6 hours interval.
4) Preoperative shock state was observed in 7 patients(14%) and 5 of them(71%) were died.
5) 43 patients(86%) with pancreatic injuries have at least one associated injury, with an average of 2 associated intraabdominal injuries per patients. There are mesentery and retroperitoneum, kidney, liver and duodenum in order of frequency.
6) No significant difference in mortality and morbidity according to operation method.
7) Complications were developed in 27 of 47 patients surviving more 48 hours. There are respiratory problem, wound infection, renal failure, intraabdominal abscess, pancreatic fistula, pancreatic abscess and pseudocyst in order of frequency.
8) High mortality rate in Lucas's class III and IV and in over than 10 score of APACHE II system.
9) 12 patients(24%) were died due to sepsis, renal failure, hypovolemic shock and brain death in order of frequency.
|