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

ABSTRACT

Objective To investigate the diagnosis and management of pancreatic injury. Methods The clinical data of 23 patients suffering from pancreatic injury treated by surgery in recent 15 years were analyzed retrospectively. According to the pancreas organ injury scale of the American Association for the Surgery of Trauma, there were 8 cases in grade I, 8 in grade II, 5 in grade III, 1 in grade IV and 1 in grade V. Results Only 2 patients were diagnosed preoperatively out of the 19 patients.About 63.2%(12/19)of the cases had elevated levels of serum amylase. All the patients were cured.In this series,8 cases occurred external pancreatic fistula, 4 pseudocysts, 2 intra-abdominal infections and 1 hyperglycemia postoperatively. Internal pancreatic fistulas were found in all the non operation patients. Conclusions The serum amylase determinations is neither sensitive nor specific for diagnosis of pancreatic injury. Early diagnosis and correct operative pracedure are important to decrease the postoperative complications and improve the outcome.