Thomas Harun, Madanur Mansoor, Bartlett Adam, Marangoni Gabriele, Heaton Nigel, Rela Mohamed
Institute of Liver Studies, Kings College School of Medicine at Denmark Hill, Camberwell, Kings College Hospital, London, United Kingdom.
Pancreas. 2009 Mar;38(2):113-6. doi: 10.1097/MPA.0b013e31818d92d7.
Pancreatic trauma is rare and often missed during initial assessment of patients with abdominal trauma. This study reviews our experience of managing pancreatic trauma at a tertiary referral center and discusses the diagnostic and therapeutic challenges.
A retrospective study of our prospectively maintained hepato-pancreatico-biliary database for 12 years preceding December 2007.
Twenty-eight patients (23 males, 10 children) with a median age of 11.5 years (range, 6-16 years) in children and 27.5 years (range, 17-54 years) in adults were identified. Nineteen of the 28 had pancreatic duct injury of which 15 were missed on initial evaluation and referred after conservative management (n = 9) or laparotomy (n = 6). Twenty-one patients developed complications including abdominal collections (n = 10), pancreatic fistulae (n = 9), and pseudocysts (n = 2). There were 2 deaths (7%), both of which were associated with multiple intra-abdominal injuries. At a median follow-up of 7.5 months (range, 3-44 months), 19 of 23 patients were asymptomatic and had been discharged from follow-up.
Pancreatic trauma in the United Kingdom is mainly the result of blunt trauma and most commonly affects young males. The presence of pancreatic duct disruption accounts for most of the complications, and in the absence of associated injuries, mortality is rare.
胰腺创伤较为罕见，在对腹部创伤患者进行初始评估时常常被漏诊。本研究回顾了我们在一家三级转诊中心处理胰腺创伤的经验，并讨论了诊断和治疗方面的挑战。
对我们前瞻性维护的2007年12月之前12年的肝胰胆数据库进行回顾性研究。
共确定了28例患者（23例男性，10例儿童），儿童的中位年龄为11.5岁（范围6 - 16岁），成人的中位年龄为27.5岁（范围17 - 54岁）。28例中有19例存在胰管损伤，其中15例在初始评估时被漏诊，在保守治疗（n = 9）或剖腹手术后（n = 6）才被转诊。21例患者出现并发症，包括腹腔积液（n = 10）、胰瘘（n = 9）和假性囊肿（n = 2）。有2例死亡（7%），均与多发腹部损伤相关。中位随访7.5个月（范围3 - 44个月），23例患者中有19例无症状且已结束随访。
在英国，胰腺创伤主要是钝性创伤的结果，最常影响年轻男性。胰管破裂是导致大多数并发症的原因，在无相关损伤的情况下，死亡率较低。
