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The Shock Trauma Manual of Operative Techniques pp 243–263Cite as

Pancreas and Duodenum

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Abstract

The pancreas and the duodenum are retroperitoneal organs intimately associated with one another and deeply positioned in the mid-abdomen. Isolated injuries are infrequent from either blunt or penetrating mechanisms as these organs are surrounded by numerous other vital structures. Early mortality is high due to associated injuries to the vascular or central nervous systems, but delays in diagnosis and complications in the treatment of pancreatic and duodenal injuries contribute to later deaths from sepsis and multiple organ dysfunction. Even in tertiary trauma centers, these injuries are rare. Consequently, surgeons generally possess limited, first-hand experience in operative care and overall management. A query of the Shock Trauma Center Registry for the inclusive period between January 2000 and September 2013 identified only 466 pancreatic and/or duodenal injuries (34/year) from a total of 68,053 trauma admissions.

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References

  1. Biffl WL. Trauma. 7th ed. New York: McGraw-Hill; 2013. Chapter 32, Duodenum and pancreas. p. 603–19.

    Google Scholar 

  2. Howard JM, Hess W. History of the pancreas: mysteries of a hidden organ. New York: Kluwer Academic; 2002. Chapter 7, Trauma to the pancreas. p. 363–98.

    Google Scholar 

  3. Travers B. Rupture of the pancreas. Lancet. 1827;12:384.

    Google Scholar 

  4. Mickulicz-Radicki JV. Surgery of the pancreas. Ann Surg. 1903;38:1–8.

    Article  Google Scholar 

  5. Cave WH. Duodenal injuries. Am J Surg. 1946;72:26–31.

    Article  CAS  PubMed  Google Scholar 

  6. Vaughan III GD, Frazier OH, Graham DY, et al. The use of pyloric exclusion in the management of severe duodenal injuries. Am J Surg. 1977;134:785–90.

    Article  PubMed  Google Scholar 

  7. Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. J Trauma. 2011;71:1869–72.

    Article  PubMed  Google Scholar 

  8. Brenner ML, Moore LJ, DuBose JJ, et al. A clinical series of resuscitative endovascular balloon occlusion of the aorta for hemorrhage control and resuscitation. J Trauma Acute Care Surg. 2013;75:506–11.

    Article  PubMed  Google Scholar 

  9. Subramanian A, Dente CJ, Feliciano DV. The management of pancreatic trauma in the modern era. Surg Clin North Am. 2007;87:1515–32.

    Article  PubMed  Google Scholar 

  10. Jurkovich GJ. ACS surgery: principles and practice. Hamilton, Ontario: BC Decker Inc; 2008. Chapter 9, Injuries to the pancreas and duodenum. p. 1–15.

    Google Scholar 

  11. Moore EE, Cogbill TH, Malangoni MA, et al. Organ injury scaling II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30:1427–9.

    Article  CAS  PubMed  Google Scholar 

  12. Bulger EM, Jurkovich GJ. Operative management of pancreatic trauma. Oper Tech Gen Surg. 2000;2:221–33.

    Article  Google Scholar 

  13. Biffl WL, Moore EE, Croce M, et al. Western Trauma Association Critical Decisions in Trauma: management of pancreatic injuries. J Trauma. 2013;75:941–6.

    Article  Google Scholar 

  14. Heuer M, Taeger G, Kaiser GM, et al. No further incidence of sepsis after splenectomy for severe trauma: a multi-institutional experience of the trauma registry of the DGU with 1,630 patients. Eur J Med Res. 2010;15:258–65.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Pachter HL, Hofstetter SR, Liang HG, et al. Traumatic injuries to the pancreas: the role of distal pancreatectomy with splenic preservations. J Trauma. 1989;29:1352–5.

    Article  CAS  PubMed  Google Scholar 

  16. Dawson D, Scott-Conner C. Distal pancreatectomy with splenic preservation: the anatomic basis for a meticulous operation. J Trauma. 1986;26:1142.

    Article  CAS  PubMed  Google Scholar 

  17. Lin BC, Liu NJ, Fang JF, et al. Long-term results of endoscopic stent placement in the management of blunt major pancreatic duct injury. Surg Endosc. 2006;20:1551–5.

    Article  PubMed  Google Scholar 

  18. Thompson CM, Shalhub S, DeBoad ZM, et al. Revisiting the pancreaticoduodenectomy for trauma: a single institution’s experience. J Trauma. 2013;75:225–8.

    Article  Google Scholar 

  19. Britt LD. Duodenal primary repair, diversion and exclusion. Oper Tech Gen Surg. 2000;2:234–9.

    Article  Google Scholar 

  20. Gullotto C, Paulson EK. CT-guided percutaneous drainage of a duodenal hematoma. AJR. 2005;184:231–3.

    Article  PubMed  Google Scholar 

  21. Vargish T. Pyloric exclusion. Oper Tech Gen Surg. 2000;2:278–82.

    Article  Google Scholar 

  22. Walt AJ. Textbook of penetrating trauma. Baltimore: Williams & Wilkins; 1996. Commentary. p. 641–2.

    Google Scholar 

  23. Jurkovich GJ. Digestive tract surgery: a text and atlas. Philadelphia: Lippincott-Raven Publishers; 1996. Chapter 29, Pancreaticoduodenal trauma. p. 943–61.

    Google Scholar 

  24. Recinos G, DuBose JJ, Teixeira PGR, et al. Local complications following pancreatic trauma. Injury. 2009;40:516–20.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Trauma and Critical Care, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA

    Raymond Fang M.D., F.A.C.S.

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  1. Raymond Fang M.D., F.A.C.S.
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Editors and Affiliations

  1. Department of Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA

    Thomas M. Scalea

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© 2015 Springer Science+Business Media New York

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Fang, R. (2015). Pancreas and Duodenum. In: Scalea, T. (eds) The Shock Trauma Manual of Operative Techniques. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2371-7_13

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  • DOI: https://doi.org/10.1007/978-1-4939-2371-7_13

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2370-0

  • Online ISBN: 978-1-4939-2371-7

  • eBook Packages: MedicineMedicine (R0)

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