Pancreatic Trauma

Pancreatic Trauma is a topic covered in the 5-Minute Emergency Consult.

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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 muscle and SC tissue
  • Malpositioned seat belts and child abuse need to be considered in small children
  • Children will less often present with hypotension

Etiology

  • Penetrating trauma: Most common mechanism
  • 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

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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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 muscle and SC tissue
  • Malpositioned seat belts and child abuse need to be considered in small children
  • Children will less often present with hypotension

Etiology

  • Penetrating trauma: Most common mechanism
  • 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

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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