The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

Abstract

Study objective: To assess the efficacy of computed tomography (CT) in evaluating patients with pancreatic trauma.

Methods: We undertook a retrospective review of all blunt trauma patients admitted to the Chi-Mei Medical Center from January 2004 to June 2006. Every patients underwent abdominal CT scan in emergency department and the CT scans were obtained with a four-slice helical CT. Diagnosis of a pancreatic injury in these patients was by surgical observation or by CT findings. Radiographic pancreatic injuries were classified as deep or superficial lesions. Deep lesions were defined as the hematomas or lacerations >50% thickness of the pancreas. Superficial lesions were described as the hematomas or lacerations <50% thickness of the pancreas; pancreatic edema; and focal fluid accumulation around the pancreas

Results: Nineteen patients with pancreatic trauma, fourteen males and five females, average age 40.6 ± 21.4 years, were included. Most patients (73.7%) with pancreatic trauma had associated organ injuries. CT was performed in all patients and laparotomy in 14 patients. CT was 78.9% sensitive in detecting pancreatic trauma. All deep pancreatic lesions revealed on CT required surgical treatment, and complication was discovered in two patients undergoing delayed surgery. Superficial lesions were managed conservatively.

Conclusion: Four-slice helical CT can detect most pancreatic trauma and provide practical therapeutic guidance. Delayed operation might result in complications and is associated with prolonged hospital stays.

Figure 1

The CT findings, operative results, mortality and complications of the study population.

Figure 2

The left picture is a patient with superficial pancreatic lesion and the right picture is a patient with deep pancreatic lesion. The arrow head shows pancreatic swelling with focal fluid accumulation around the pancreas. The arrow shows a deep laceration transected the pancreas.