Diagnosis and treatment of severe pancreatic trauma / 中国普通外科杂志

ABSTRACT

Objective To evaluate the diagnosis and treatment of severe pancreatic trauma(SPT). Methods The clinical data of 32 patients with transected pancreatic trauma(grade 3-5) admitted into our hospital in recent 20 years were retrospectively analyzed. Results Twenty patients were in grade 3, 10 in grade 4,and 2 in grade 5. Operations were performed on all 32 patients. Twenty-five recovered, and 7 died. The mortality was 21.9%.Before the operation, peritoneal lavage fluid amylase rose in 10 patients(50%),and serum amylase rose in 12 patients(60%). Imaging examination included ultrasonography in 10 (diagnosed in 3),and CT in 8 (diagnosed in 3). Diagnosis was established only in 10 patients before the operation. Complications included fistula, abscess and pseudocyst. Conclusions Incidence of associated trauma is high. The preoperative diagnosis of pancreatic trauma is difficult. The rates of morbidity and mortality are high. Early diagnosis, careful exploration and proper surgery are very important. Intraoperative pancreatography or ultrasonographic scanning is useful in diagnosis. Somatostatin and human growth hormone are useful in the treatment.