[Closed trauma of the pancreas--diagnostic approach].

OBJECTIVE

To review patients who presented lesions of the pancreas following blunt abdominal trauma, in order to determine which elements contributed to or on the contrary delayed the diagnosis. Construction of a diagnostic procedure which could be followed in order to maximize the rapidity and efficency of treatment.

DESIGN

Retrospective study.

PATIENTS AND METHOD

Patients from 1985 to 1997 having suffered blunt trauma were studied. The lesions of the pancreas were classified according to Lucas. The grounds for indication and the information that the echography, the CT-Scan and the wirsungographie brought to the diagnosis was determined for each patient. Elements which delayed diagnosis were retrospectively evaluated.

RESULTS

We treated 11 patients having suffered blunt abdominal trauma resulting in pancreatic damage. 7 patients were operated. Five had emergency laparotomies. Three of these were unable to reveal an existing rupture of the pancreatic duct.

CONCLUSIONS

Surgical exploration is difficult and pancreatic lesions are frequently missed. The wirsungography done before or during the operation should, therefore, be more often used as a diagnostic tool.