A Clinical Study of Pancreatic Injuries
We evaluated 48 patients with pancreatic injuries. The trauma was blunt in 46 of the patients. Forty-five patients had associated injuries, especially to the gastrointestinal tract, liver, or major vessels. The mean Injury Severity Score was 20.1. Ten patients died from hemorrhage or sepsis, which was unrelated to the type of the pancreatic injury. There was no significant relation between the patients' serum amylase level on admission and the type of pancreatic injury. A CT scan can detect complete transection injuries. An emergent operation was carried out for thirty-nine patients. Drainage was mainly performed for type I injuries, suture for type II injuries. Nine patients had pancreatic ductal injury (type Ⅲ), three of them were underwent distal pancreatectomy with splenectomy and one without splenectomy. Pancreaticojejunostomy was carried out for one patient. A pancreatic pseudocyst developed in four patients, but only one case needed percutaneous drainage. Inspite of the recent development of image examinations, exact diagnosis and treatment for pancreatic injury still remains difficult. Careful management is important for each case of pancreatic injury.
