II. Pathophysiology

  1. Rarely injured due to its fixed and protected position in the Retroperitoneum

III. Causes

  1. Blunt injury to the epigastrium (e.g. Bicycle handlebar injury)

IV. Symptoms

  1. Nausea or Vomiting
  2. Localized Epigastric Pain radiating into the chest and Shoulders
    1. Biphasic pain timing
    2. Pain worse with initial injury and subsides over subsequent 2 hours
    3. Pain recurrs and worsens 6-8 hours after injury

V. Signs

  1. Abdominal Wall Ecchymosis
  2. Focal abdominal tenderness
  3. Abdominal guarding
  4. Abdominal Rebound Tenderness

VI. Labs

  1. Comprehensive Metabolic Panel
  2. Complete Blood Count
  3. Serum Lipase

VII. Imaging

  1. CT Abdomen and Pelvis with IV Contrast
    1. First-line study in suspected pancreatic injury
  2. Endoscopic Retrograde Cholangiopancreatography (ERCP) or MRCP
    1. Consider in suspected pancreatic duct injury (missed on CT Abdomen)

VIII. Management

  1. Aggressive intravenous hydration (Lactated Ringers)
  2. Correct electrolyte abnormalities
  3. Evaluate for associated intraabdominal injuries

IX. Prognosis

  1. Pancreatic Trauma is associated with increased morbidity and mortality

X. References

  1. Dreis (2020) Crit Dec Emerg Med 34(7):3-21

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Related Studies

Ontology: Injury of pancreas (C0273163)

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