Karl H W, Chandler J G
Am J Surg. 1977 Nov;134(5):549-54. doi: 10.1016/0002-9610(77)90431-7.
Pancreatic trauma, regardless of etiology, has been consistently associated with a mortality of 20 percent and enormous morbidity. Twenty-five pancreatic injuries, including four solitary wounds of the pancreas, were analyzed to determine why pancreatic trauma should have such an adverse prognosis. Eleven patients were victims of blunt trauma and fourteen sustained gunshot wounds. There were no stab wounds. The important determinants of mortality were associated injuries to major vessels, wounds of the head of the gland, and failure to adequately control leaking exocrine secretion. All four deaths were directly related to massive hemorrhage; in two instances leakage of pancreatic juice was also implicated. With the exception of benign solitary blunt wounds of the pancreas to the body of the gland immediately ventral to the spinal column, an injury of the pancreas is evidence that the abdomen has been subjected to severe trauma, which predisposes the patient to a high mortality and morbidity. The pancreatic injury, interacting with other abdominal injuries, is likely to be a cause of significant mortality and to result in complications that will prolong the patient's hospitalization.
胰腺创伤，无论病因如何，死亡率一直维持在20%，且发病率极高。分析了25例胰腺损伤病例，其中包括4例胰腺单发创伤，以确定为何胰腺创伤会有如此不良的预后。11例患者为钝器伤受害者，14例遭受枪伤。无刺伤病例。死亡率的重要决定因素包括主要血管的相关损伤、胰腺头部创伤以及未能充分控制外分泌液渗漏。所有4例死亡均直接与大出血有关；在两例中，胰液渗漏也有牵连。除了胰腺体部紧邻脊柱前方的良性单发钝器伤外，胰腺损伤表明腹部遭受了严重创伤，这使患者易出现高死亡率和高发病率。胰腺损伤与其他腹部损伤相互作用，很可能是导致显著死亡率的原因，并会引发延长患者住院时间的并发症。
