gms | German Medical Science

Introduction: Only 1–5% of the patients with blunt abdominal trauma and 8% of the patients with penetrating trauma acquire an injury of the pancreas. Concurrent injuries are present in up to 70% of these patients, explaining the delay in the diagnosis of a pancreatic injuries.

Materials and methods: We performed a retrospective analysis of our prospective trauma database between 2002–2009. The primary diagnostic test was a CT scan. Pancreatic injuries were graded according to the Moore classification. Patients were followed by questionnaire, abdominal ultrasound and measurement of blood glucose and stool elastase.

Results: There were 6 patients (4 male, 2 female) with a traumatic injury of the pancreas, out of how 2,148 patients with possible abdominal trauma at the emergency station. The median age was 28 years (19–80). We found an even distribution of the injuries: grade I, III, IV and V: 1 patient each, grad II: 2 patients. 5 patients (83%) suffered concurrent intraabdominal injuries, one patient incurred concurrent rib fractures. We found the following accidents: 2 horseback riding with hoof kick, one skiing, one traffic crash and one scooter, 1 penetrating abdominal trauma. Three patients were treated by interventional drain placement, 2 by a left resection of the pancreas and 1 by direct suture of the pancreas. One patient developed a pseudocyst, 2 patients developed a pancreatic fistula Grade A and B; all healed spontaneously. The mean time in hospital was 18 days (10–47). The median follow up was 56 months (1–98). There were no exocrine pancreatic insufficiency, nor diabetes.

Conclusion: Traumatic injuries of the pancreas are rare and should be sought actively in blunt and penetrating abdominal trauma. Although they affect young patients and result in prolonged hospitalization the long-term prognosis is good with a normal exocrine and endocrine function of the pancreas.