Pancreatic Trauma

Excerpt

“Eat when you can, sleep when you can, and don’t mess with the pancreas." This age-old surgical mantra is a saying to live by, but what happens if the pancreas has already been “messed with?" Pancreatic trauma is a rare but potentially catastrophic injury that can be very difficult to diagnose. Unlike the liver, kidney or spleen, conventional imaging modalities miss subtle findings associated with pancreatic injury. Post-traumatic pancreatitis may not cause alterations in blood or edema for several hours after the initial event. Diagnostic testing may require magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). A delay in diagnosis leads to complications such as infection, pseudocysts, abscess, duct stricture, peritonitis, and endocrine/exocrine insufficiency which are associated with high morbidity and mortality. Incorrect classification deters proper intervention and management. A high degree of suspicion and comprehensive knowledge is required to identify, classify, and treat traumatic pancreatic effectively. This chapter is a concise overview to further aid the care for patients who suffer traumatic pancreatic injury.