Presentation
In most cases, patients present to the emergency department with inaccurate or misleading histories; some give no history of trauma, which may delay recognition of serious abdominal injuries. [ncbi.nlm.nih.gov]
’s symptoms were presented late and the trauma history was missed in the emergency department; thus, a wrong diagnosis of general pancreatitis was initially made. [jtraumainj.org]
This case report is presented for an uncommon presentation of isolated pancreatic injury following blunt trauma abdomen. Key words: Pancreas, Necrosectomy Advertisement Journal of Interdisciplinary Histopathology SUBMIT YOUR ARTICLE NOW [scopemed.org]
Entire Body System
- Feeding Difficulties
Ileus and feeding difficulty are other common challenges. Elemental tube feeding formulas are thought to provoke less pancreatic stimulation and may be better tolerated [ 7 ]. [link.springer.com]
Gastrointestinal
- Epigastric Pain
Patients with early symptoms may report brief post-traumatic epigastric pain that has completely subsided. Pain may be absent for several days, even in the case of complete transaction with avulsion of the pancreatic duct. [med-ed.virginia.edu]
Diagnosis requires high level of suspicion, usually initial symptoms are non specific and vague, presents with mid epigastric pain or back pain following trauma. [omicsonline.org]
• Dull epigastric pain or back pain – due to contained fracture of the spleen with retroperitoneal hematoma or leak. • severe peritoneal irritation 9. [slideshare.net]
Pancreatic cysts are regarded symptomatic when there is hyperamylasemia, recent-onset diabetes, severe epigastric pain, weight loss, steatorrhea, or jaundice. [radiologyassistant.nl]
Rarely, a contained fracture of the spleen with retroperitoneal hematoma or leak manifests as dull epigastric pain or back pain, but the more common scenario is for patients to exhibit severe peritoneal irritation and a positive abdominal examination [emedicine.medscape.com]
- Bilious Vomiting
She also complained of repeated bilious vomiting and distension of abdomen. Clinical examination revealed an ill-looking patient with increased heart rate and respiratory rate. She was apyrexic, conscious, well oriented. [ijri.org]
Liver, Gall & Pancreas
- Pancreatic Pain
Outcome measures evaluated were the incidence of acute pancreatitis, hyperamylasemia, and pancreatic pain. [ncbi.nlm.nih.gov]
In addition to all those you mentioned, we also partner with anesthesiologists who treat both surgical and chronic pancreatic pain, and gastroenterologists who specialize in pancreatic imaging techniques. [ucsfhealth.org]
Workup
Outline • Introduction • Relevant anatomy • Epidemiology • Etiology • Presentation • Indicators of injury • Workup • Staging • Treatment 3. [slideshare.net]
X-Ray
- Ground Glass Appearance
Ann Surg, May 1978 AXR: Fracture lumbar spine, retroperitoneal air bubbles along psoas / kidney; displacement of stomach and T colon, generalized ground glass appearance Limitation of PDL fluid to lesser sac Pancreatic lesion missed on USG due to retroperitoneal [slideplayer.com]
Treatment
PURPOSE: Treatment of blunt injury of the pancreas in children remains controversial. Some prefer nonoperative treatment, whereas others prefer operative management in selected cases. [ncbi.nlm.nih.gov]
treatment Conservative treatment About 75 – 85 % of children with pancreatic injuries receive non-surgical treatment, based on the grade of injury ( 6, 16, 21, 37 ). [tidsskriftet.no]
Prognosis
CONCLUSIONS: For a good prognosis, the first operation time after injury should be decreased and surgical technique should be simplified by damage control surgery to reduce complications as well as to prevent exacerbation of the general condition in patients [ncbi.nlm.nih.gov]
Pancreas Trauma Prognosis The outlook of pancreatic trauma depends on the severity of the injury and how soon medical attention is sought. Minor injury usually has a good outcome. [healthhype.com]
Most of these lesions are benign or slow growing and the prognosis is significantly better than with pancreatic adenocarcinoma. [bcm.edu]
[…] vein 1,2 peripancreatic fluid thickening of Gerota’s fascia injury to the pancreatic duct may not be seen directly but is inferred by the grading of the injury 1 MRI MRCP can be used to image the pancreatic duct and any associated injury Treatment and prognosis [radiopaedia.org]
Consequently, the level of injury also determines both the treatment and prognosis ( 31 ). [tidsskriftet.no]
Etiology
These injuries can result from atraumatic etiologies and blunt abdominal trauma. Atraumatic pancreatic injuries in the athlete are diagnosed and treated in a similar manner to the nonathletic patient. [ncbi.nlm.nih.gov]
NZ Med J 1974, 79 :1068–1071. 13.• Jackson WD: Pancreatitis: etiology, diagnosis, and management. Curr Opin Pediatr 2001, 13 :447–451. A review article concerning the etiology, diagnosis, and management of pediatric pancreatitis. 14. [journals.lww.com]
Outline • Introduction • Relevant anatomy • Epidemiology • Etiology • Presentation • Indicators of injury • Workup • Staging • Treatment 3. [slideshare.net]
His case demonstrates several possible etiologies for VAPAs, including unrecognized injury from penetrating trauma, instrumentation of the abdomen during exploration, or sequelae of pancreatic injury and leak. [oatext.com]
Pancreatic fistulas: etiology, consequences and treatment. Gastroenterologist 4: 238 - 244. Google Scholar | Medline Kudsk KA, Temizer D, Ellison EC, Cloutier CT, Buckley DC, Carey LC. 1986. [doi.org]
Epidemiology
Sports specific epidemiologic data collection and analysis are important elements in the development of evidence-based interventions. [ncbi.nlm.nih.gov]
The use of multiofactorial epidemiologic frameworks [ 45–47,48• ] can lead to an improved sports-specific injury analysis. [journals.lww.com]
Outline • Introduction • Relevant anatomy • Epidemiology • Etiology • Presentation • Indicators of injury • Workup • Staging • Treatment 3. [slideshare.net]
“We need smart screening and individualized treatments based on family history, epidemiology, biomarkers and genetics.” [hopkinsmedicine.org]
Pathophysiology
BACKGROUND: Premature activation of pancreatic digestive enzymes and profound changes of levels of certain biochemical compounds have been implicated in the pathophysiology of acute pancreatitis. [ncbi.nlm.nih.gov]
To the Editor: The article by Fernández-del Castillo et al. implicating calcium administration in the development of pancreatic cellular injury (Aug. 8 issue) 1 was of interest but was misleading on pathophysiologic and biostatistical grounds, since defining [nejm.org]
Unlike others on this topic, this text demonstrates how the endoscope incorporates pathophysiology, diagnostic, and treatment modalities into endoscopic practice. [books.google.com]
Pathophysiology Unlike the spleen, few data suggest that preexisting primary or secondary diseases of the pancreas result in a higher risk of injury or a higher mortality rate when the pancreas is injured. [emedicine.medscape.com]
Prevention
BACKGROUND: The identification of therapeutic agents that can prevent the pancreatic injury after endoscopic retrograde cholangiopancreatography (ERCP) is of considerable importance. [ncbi.nlm.nih.gov]