Background and aims: Pancreatic trauma is a rare entity but results in significant morbidity and mortality .Our aim is to evaluate the pattern of presentation and management outcomes of pancreatic injuries in our locality.
Patients and Methods: Fifteen consecutive patients subjected to surgical management of pancreatic injuries and enrolled in a retrospective study from January 2009 to February 2012. They were 11 males and 4 females. The data recorded for each patient included demographic
information, mechanism of injury, grade of pancreatic injury according to American Association for the Surgery of Trauma grade (AAST), associated other injuries, surgical procedure and postoperative surgical outcome.
Results: A total of 15 consecutive patients with traumatic pancreatic injuries were verified and treated surgically during the study period. 11 of them (73%) had penetrating abdominal trauma, while the remaining (27%) presented with blunt trauma. Associated other organ injuries were found in 14 patients (93%). Grading of pancreatic injuries was based on the final surgical findings according to AAST scoring. Grade I and II (8 patients) were managed by external drainage .Grade III (4 cases) was treated by distal pancreatectomy while grade IV (2 patients) was managed by extended distal pancreatectomy. Splenectomy was performed to all patients with grade III and IV except one child where the spleen was preserved. The remaining case with grade V was managed by Whipple pancreaticoduodenectomy. Postoperative morbidity and mortality was 47% and 20% respectively.
Conclusions: Pancreatic trauma is commonly caused by penetrating injuries and associated with other organ injuries. Most pancreatic traumas can be treated by external drainage. However, the surgical outcome of pancreatic injuries is accompanied with high incidence of morbidity and mortality.