• Medicina clinica · May 2023

    Review

    Diagnosis and treatment of pancreatic trauma.

    • Valentina García Reyes, Bruno Scarlatto, and William Manzanares.
    • Cátedra de Medicina Intensiva, Centro de Tratamiento Intensivo del Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
    • Med Clin (Barc). 2023 May 26; 160 (10): 450455450-455.

    AbstractPancreatic trauma is a rare but potentially lethal entity which requires a high level of clinical suspicion. Early diagnosis and assessment of the integrity of the pancreatic duct are essential since ductal injury is a crucial predictor of morbimortality. Overall mortality is 19%, which can rise to 30% in cases of ductal injury. The diagnostic and therapeutic approach is multidisciplinary and guided by a surgeon, imaging specialist and ICU physician. Laboratory analysis shows that pancreatic enzymes are frequently elevated, which is a low specificity finding. In hemodynamically stable patients, the posttraumatic condition of the pancreas is firstly evaluated by the multidetector computed tomography. Moreover, in case of suspicion of ductal injury, more sensitive studies such as Endoscopic Retrograde Cholangiopancreatography or cholangioresonance are needed. This narrative review aims to analyze the etiopathogenesis and pathophysiology of pancreatic trauma and discuss its diagnosis and treatment. Also, the most clinically relevant complications will be summarized.Copyright © 2023 Elsevier España, S.L.U. All rights reserved.

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