Pancreatic Trauma

Basics

Description

  • Direct epigastric blow compressing pancreas against vertebral column resulting in blunt trauma
  • Injury to pancreas from penetrating object

Pediatric Considerations

  • Trauma affects proportionately larger areas, leading to multisystem injuries
  • Children have less protective abdominal muscle and SC tissue
  • Malpositioned seat belts and nonaccidental trauma needs to be considered in small children
  • Children are less likely to present with hypotension

Etiology

  • Penetrating trauma: Most common mechanism in the US
  • Blunt trauma: Deep location of pancreas requires significant force to cause injury:
    • Steering wheel, seat belts, or bicycle handlebars to abdomen
    • In children, evaluate for nonaccidental trauma
    • Potentially higher risk with use of e-bikes and e-scooters

Commonly Associated Conditions

90% of pancreatic injuries associated with injuries to adjacent structures:

  • Liver, stomach
  • Major arteries and veins
  • Spleen, kidney
  • Duodenum, colon, small bowel
  • Common bile duct, gallbladder
  • Spine: Chance fracture

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