Abstract
Blunt traumatic injury to the pancreas is uncommon, accounting for less than 2 % of all cases of blunt abdominal trauma. Diagnosis and accurate grading of pancreatic injury is important, as the presence of pancreatic ductal injury mandates operative intervention, and delayed recognition of ductal injury frequently results in significant morbidity such as necrotizing pancreatitis or pseudocyst formation and a patient’s death. When a definitive diagnosis is delayed for more than 24 h, up to 40 % of patients are at risk of death, as opposed to about 10 % of those patients operated on within 24 h.
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Bradley EL, Young Jr PR, Chang MC, et al. Diagnosis and initial management of blunt pancreatic trauma: guidelines from a multiinstitutional review. Ann Surg. 1998;227:861–9.
Brook OR, Fischer D, Militianu D, et al. Pseudopancreatitis in trauma patients. AJR Am J Roentgenol. 2009;193:W193–6.
Bruno O, Brancatelli G, Sauvanet A, et al. Utility of CT in the diagnosis of pancreatic fistula after pancreaticoduodenectomy in patients with soft pancreas. AJR Am J Roentgenol. 2009;193:W175–80.
Chapman VM, Rhea JT, Sacknoff R, et al. CT of nontraumatic abdominal fluid collections after initial fluid resuscitation of patients with major burns. AJR Am J Roentgenol. 2004;182:1493–6.
Cirillo RL, Koniaris LG. Detecting blunt pancreatic injuries. J Gastrointest Surg. 2002;6:587–98.
Drake LM, Anis M, Lawrence C. Accuracy of magnetic resonance cholangiopancreatography in identifying pancreatic duct disruption. J Clin Gastroenterol. 2012;46:696–9.
Fragulidis GP, Arkadopoulos N, Vassiliou I, et al. Pancreatic leakage after pancreaticoduodenectomy: the impact of the isolated jejunal loop length and anastomotic technique of the pancreatic stump. Pancreas. 2009;38:e177–82.
Fulcher AS, Turner MA, Yelon JA, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: preliminary findings. J Trauma. 2000;48:1001–7.
Gillams AR, Kurzawinski T, Lees WR. Diagnosis of duct disruption and assessment of pancreatic leak with dynamic secretin-stimulated MR cholangiopancreatography. AJR Am J Roentgenol. 2006;186:499–506.
Gomez MA, Besson M, Scotto B, et al. MR imaging in the evaluation of blunt pancreatic trauma. J Radiol. 2004;85:414–7.
Gore RM, Levine MS. Textbook of gastrointestinal radiology. Philadelphia: Saunders; 2007.
Hashimoto M, Koga M, Ishiyama K, et al. CT features of pancreatic fistula after pancreaticoduodenectomy. AJR Am J Roentgenol. 2007;188:W323–7.
Heitsch RC, Knutson CO, Fulton RL, et al. Delineation of critical factors in the treatment of pancreatic trauma. Surgery. 1976;80:523–9.
Ho C-K, Kleeff J, Friess H, et al. Complications of pancreatic surgery. HPB. 2005;7:99–108.
Kao LS, Bulger EM, Parks DL, et al. Predictors of morbidity after traumatic pancreatic injury. J Trauma. 2003;55:898–905.
Lee WJ, Foo NP, Lin HJ, et al. The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience. J Trauma Manag Outcomes. 2011;5:1.
Leppaniemi AK, Haapiainen RK. Risk factors of delayed diagnosis of pancreatic trauma. Eur J Surg. 1999;165:1134–7.
Linsenmaier U, Wirth S, Reiser M, et al. Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology. Radiographics. 2008;28:1591–602.
Lucas CE. Diagnosis and treatment of pancreatic and duodenal injury. Surg Clin North Am. 1977;57:49–65.
Lucas CE, Ledgerwood AM. Factors influencing outcome after blunt duodenal injury. J Trauma. 1975;15:839–46.
Madiba TE, Mokoena TR. Favourable prognosis after surgical drainage of gunshot, stab or blunt trauma of the pancreas. Br J Surg. 1995;82:1236–9.
Matos C, Metens T, Deviere J, et al. Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology. 1997;203:435–41.
Matsubara J, Okusaka T, Morizane C, et al. Ultrasound-guided percutaneous pancreatic tumor biopsy in pancreatic cancer: a comparison with metastatic liver tumor biopsy, including sensitivity, specificity, and complications. J Gastroenterol. 2008;43:225–32.
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.
Nirula R, Velmahos GC, Demetriades D. Magnetic resonance cholangiopancreatography in pancreatic trauma: a new diagnostic modality? J Trauma. 1999;47:585–7.
Oniscu GC, Parks RW, James Garden O. Classification of liver and pancreatic trauma. HPB. 2006;8:4–9.
Paspulati RM. Multidetector CT of the pancreas. Radiol Clin North Am. 2005;43:999–1020, viii.
Phelan HA, Velmahos GC, Jurkovich GJ, et al. An evaluation of multidetector computed tomography in detecting pancreatic injury: results of a multicenter AAST study. J Trauma. 2009;66:641–6; discussion 646–647.
Raty S, Sand J, Lantto E, et al. Postoperative acute pancreatitis as a major determinant of postoperative delayed gastric emptying after pancreaticoduodenectomy. J Gastrointest Surg. 2006;10:1131–9.
Ryan MF, Hamilton PA, Sarrazin J, et al. The halo sign and peripancreatic fluid: useful CT signs of hypovolaemic shock complex in adults. Clin Radiol. 2005;60:599–607.
Scollay JM, Yip VS, Garden OJ, et al. A population-based study of pancreatic trauma in Scotland. World J Surg. 2006;30:2136–41.
Shanmuganathan K. Multi-detector row CT imaging of blunt abdominal trauma. Semin Ultrasound CT MR. 2004;25:180–204.
Smego DR, Richardson JD, Flint LM. Determinants of outcome in pancreatic trauma. J Trauma. 1985;25:771–6.
Soto JA, Alvarez O, Munera F, et al. Traumatic disruption of the pancreatic duct: diagnosis with MR pancreatography. AJR Am J Roentgenol. 2001;176:175–8.
Takishima T, Hirata M, Kataoka Y, et al. Pancreatographic classification of pancreatic ductal injuries caused by blunt injury to the pancreas. J Trauma. 2000;48:745–51; discussion 751–742.
Teh SH, Sheppard BC, Mullins RJ, et al. Diagnosis and management of blunt pancreatic ductal injury in the era of high-resolution computed axial tomography. Am J Surg. 2007;193:641–3; discussion 643.
Venkatesh SK, Wan JM. CT of blunt pancreatic trauma: a pictorial essay. Eur J Radiol. 2008;67:311–20.
Wilson RH, Moorehead RJ. Current management of trauma to the pancreas. Br J Surg. 1991;78:1196–202.
Yang L, Zhang XM, Xu XX, et al. MR imaging for blunt pancreatic injury. Eur J Radiol. 2010;75:e97–101.
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Park, J.H., Lee, K.H. (2014). Trauma and Post-treatment Complications of the Pancreas. In: Choi, B. (eds) Radiology Illustrated: Hepatobiliary and Pancreatic Radiology. Radiology Illustrated. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35825-8_21
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DOI: https://doi.org/10.1007/978-3-642-35825-8_21
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