Management of pancreatic trauma in adult patients at tertiary care institute of Gujarat, India
Abstract
Background and Aim: Pancreatic trauma is rare compared to other solid organ injuries of the abdomen. These injuries are difficult to diagnose and pose a problem in treatment strategy. This retrospective study aims to report our tertiary center experience in the management of pancreatic trauma.
Material and Methods: The present study is one and half year observational study of 30 patients who underwent pancreatic trauma management in the Department of Surgery, tertiary care institute of Gujarat. Demographic data and baseline characteristics were recorded, including age, sex, medical co-morbidities, mechanism of pancreatic trauma, length of the hospital stay, and associated extrapancreatic injuries. All patients underwent a CT scan for the diagnosis of pancreatic injury. Grading of pancreatic trauma was carried out according to the American Association for surgery for Trauma (AAST).
Results: Road traffic accident (RTA) (n=20) was the leading cause of pancreatic trauma in the study population followed by fall from height (n=7) and assault (n=3). The majority of the study population had Grade III pancreatic injury (n=12) followed by Grade IV (n=8), Grade II (n=7), and Grade I (n=3) injuries. No patients had Grade V injury. Isolated pancreatic trauma was seen in 13 patients. Associated liver and spleen injury was seen in 15 patients. Renal trauma was seen in 2 patients. The extra-abdominal injury was seen to be associated with pancreatic injury in 7 patients.
Conclusion: Pancreatic trauma can be managed conservatively irrespective of the grade of injury supported by radiological percutaneous drainage and pancreatic duct stenting in selective cases.
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