Gholson C F, Sittig K, Favrot D, McDonald J C
Department of Medicine, Louisiana State University Medical Center, Shreveport.
South Med J. 1994 Sep;87(9):902-4. doi: 10.1097/00007611-199409000-00008.
Three patients were admitted with severe abdominal pain that began after an asymptomatic latent period following blunt trauma to the abdomen. During initial medical evaluation 3 months to 1 year after the trauma, serum amylase levels were normal or minimally elevated, and computed tomography scanning revealed edema and/or pseudocyst formation in the tail of the pancreas. Pancreatography showed ductal stenosis or obstruction in the midbody of the pancreas in each patient. At surgery, chronic pancreatitis in the tail was clearly demarcated from the normal head of the gland. Distal pancreatectomy was curative. Blunt traumatic pancreatic ductal injury may occur without typical immediate posttraumatic acute pancreatitis. Chronic distal pancreatitis following an asymptomatic latent period may culminate in delayed admission months to years after the initial injury. Endoscopic retrograde cholangiopancreatography should be considered for evaluation of patients with chronic abdominal pain and prior blunt trauma to the abdomen.
三名患者因钝性腹部外伤后无症状潜伏期后出现严重腹痛入院。在创伤后3个月至1年的初始医学评估期间，血清淀粉酶水平正常或轻度升高，计算机断层扫描显示胰腺尾部有水肿和/或假性囊肿形成。胰管造影显示每名患者胰腺体部有导管狭窄或阻塞。手术时，胰腺尾部的慢性胰腺炎与正常的胰腺头部界限清晰。远端胰腺切除术可治愈。钝性创伤性胰管损伤可能在没有典型的创伤后立即发生急性胰腺炎的情况下出现。无症状潜伏期后的慢性远端胰腺炎可能在初次损伤数月至数年后导致延迟入院。对于有慢性腹痛且既往有钝性腹部外伤史的患者，应考虑进行内镜逆行胰胆管造影以进行评估。
