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2.1
Pancreatic Injury
Injury of Pancreas

Images

WIKIDATA, Public Domain
WIKIDATA, Public Domain

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

  • Nightmare

    If you notice your child having nightmares, flashbacks, nervousness, irritability or any other concerning emotional symptoms please speak with the trauma surgery provider. [cincinnatichildrens.org]

  • Inguinal Hernia

    The patient had no known history of chronic disease, there was no routine drug usage and the patient had no surgery history except anterior mesh herniorrhaphy due to left inguinal hernia 20 years ago. [clinmedjournals.org]

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]

    Symptoms of radiating epigastric pain to the back, nausea, and vomiting are also seen with the more commonly injured adjacent viscera. An abdominal exam is reported to have a false negative rate of 34% on initial evaluation. [ncbi.nlm.nih.gov]

    • 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]

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]

Most of these patients also have other associated injuries and thus a thorough workup is required. Mild pancreatic injury can be managed conservatively but disruption of the duct usually requires surgery. [ncbi.nlm.nih.gov]

[…] to rule out pancreatic injury, especially in the first 6 hours of injury. (2) USG abdomen: Most patients with penetrating abdominal trauma associated with hypotension, peritonitis, or evisceration proceed to the operating room without much diagnostic workup [journals.lww.com]

Sections Pancreatic Trauma Overview Problem Epidemiology Etiology Pathophysiology Presentation Indications Relevant Anatomy Contraindications Show All Workup Laboratory Studies Imaging Studies Other Tests Diagnostic Procedures Histologic Findings Staging [emedicine.medscape.com]

Treatment

Operative treatment was indicated at that time due to the failure of interventional drainage treatment. Exploratory laparotomy and intraperitoneal lavage were performed, and a drainage remained in situ. [hindawi.com]

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]

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]

MRI MRCP can be used to image the pancreatic duct and any associated injury Treatment and prognosis Delayed diagnosis raises both the mortality and morbidity of traumatic pancreatic injuries, both of which are high, with a mortality rate of up to 20% [radiopaedia.org]

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]

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]

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]

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]

For more injury prevention tips and resources visit our Comprehensive Children’s Injury Center. [cincinnatichildrens.org]

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