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Pancreatic Trauma
Aka: Pancreatic Trauma, Injury of the Pancreas
- See Also
- Abdominal Trauma
- Splenic Rupture
- Liver Laceration
- Pathophysiology
- Rarely injured due to its fixed and protected position in the Retroperitoneum
- Causes
- Blunt injury to the epigastrium (e.g. Bicycle handlebar injury)
- 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
- Signs
- Abdominal Wall Ecchymosis
- Focal abdominal tenderness
- Abdominal guarding
- Abdominal Rebound Tenderness
- Labs
- Comprehensive Metabolic Panel
- Complete Blood Count
- Serum Lipase
- 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)
- Management
- Aggressive intravenous hydration (Lactated Ringers)
- Correct Electrolyte abnormalities
- Evaluate for associated intraabdominal injuries
- Prognosis
- Pancreatic Trauma is associated with increased morbidity and mortality
- References
- Dreis (2020) Crit Dec Emerg Med 34(7):3-21