Diagnosis and treatment of 21 blunt pancreatic trauma patients

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Author:
JIAN Zhi-yuan(Department of General Surgery,Taihe Hospital,Yunyang Medical College,Shiyan 442000,China)
LAN Ming-yin(Department of General Surgery,Taihe Hospital,Yunyang Medical College,Shiyan 442000,China)
ZHOU Meng(Department of General Surgery,Taihe Hospital,Yunyang Medical College,Shiyan 442000,China)
ZHAO Yan-mei(Department of General Surgery,Taihe Hospital,Yunyang Medical College,Shiyan 442000,China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 10, Issue 06, 2010
DOI:
10.3760/cma.j.issn.1674-1935.2010.06.005
Key Word:
Pancreas;Wounds and injuries;Diagnosis;Treatment

Abstract: Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.

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