II. Pathophysiology
- Rarely injured due to its fixed and protected position in the Retroperitoneum
III. Causes
- Blunt injury to the epigastrium (e.g. Bicycle handlebar injury)
IV. Symptoms
- Nausea or Vomiting
- Localized Epigastric Pain radiating into the chest and Shoulders
- Biphasic pain timing
- Pain worse with initial injury and subsides over subsequent 2 hours
- Pain recurrs and worsens 6-8 hours after injury
V. Signs
- Abdominal Wall Ecchymosis
- Focal abdominal tenderness
- Abdominal guarding
- Abdominal Rebound Tenderness
VI. Labs
- Comprehensive Metabolic Panel
- Complete Blood Count
- Serum Lipase
VII. Imaging
-
CT Abdomen and Pelvis with IV Contrast
- First-line study in suspected pancreatic injury
-
Endoscopic Retrograde Cholangiopancreatography (ERCP) or MRCP
- Consider in suspected pancreatic duct injury (missed on CT Abdomen)
VIII. Management
- Aggressive intravenous hydration (Lactated Ringers)
- Correct Electrolyte abnormalities
- Evaluate for associated intraabdominal injuries
IX. Prognosis
- Pancreatic Trauma is associated with increased morbidity and mortality
X. References
- Dreis (2020) Crit Dec Emerg Med 34(7):3-21
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Related Studies
Concepts | Injury or Poisoning (T037) |
ICD10 | S36.2 |
SnomedCT | 210271004, 61823004 |
Italian | Traumatismo del pancreas, Trauma del pancreas |
Dutch | pancreastrauma, letsel; pancreas, pancreas; letsel, Letsel van pancreas, pancreasletsel |
French | Traumatisme pancréatique, Lésion du pancréas |
German | Pankreastrauma, Verletzung des Pankreas, Pankreasverletzung |
Portuguese | Traumatismo pancreático, Lesão traumática do pâncreas |
Spanish | Traumatismo pancreático, injuria pancreática, lesión traumática del páncreas (trastorno), lesión traumática del páncreas, Lesión traumática del páncreas |
Japanese | 膵損傷, スイソンショウ |
Czech | Poranění pankreatu, Trauma pankreatu |
English | Pancreatic injury, Pancreatic trauma, pancreatic injury, trauma pancreatic, injuries pancreas, pancreatic trauma, pancreas injury, injury of pancreas (diagnosis), injury of pancreas, injury to gastrointestinal tract pancreas, Injury of pancreas, Injury of pancreas (disorder), injury; pancreas, pancreas; injury, Injury of pancreas, NOS, Pancreatic Injury, Pancreatic Trauma |
Korean | 췌장(이자)의 손상 |
Hungarian | Pancreas trauma, Pancreas-sérülés |