Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Descriptive Analysis Of Clinical Presentation And Management Of Pancreatic Trauma At A Level I Trauma Centre

Version 1 : Received: 22 February 2021 / Approved: 23 February 2021 / Online: 23 February 2021 (11:03:14 CET)

How to cite: Al-Thani, H.; Ramzee, A.F.; Al-Hassani, A.; Strandvik, G.; El-Menyar, A. Descriptive Analysis Of Clinical Presentation And Management Of Pancreatic Trauma At A Level I Trauma Centre. Preprints 2021, 2021020510. https://doi.org/10.20944/preprints202102.0510.v1 Al-Thani, H.; Ramzee, A.F.; Al-Hassani, A.; Strandvik, G.; El-Menyar, A. Descriptive Analysis Of Clinical Presentation And Management Of Pancreatic Trauma At A Level I Trauma Centre. Preprints 2021, 2021020510. https://doi.org/10.20944/preprints202102.0510.v1

Abstract

Background: We aimed to study the frequency, management, and outcomes of patients with blunt pancreatic trauma. Methods: We reviewed the medical records for all patients admitted with pancreatic injuries between 2011 and 2017 at the only level 1 trauma center in the country. Results: There were 71 patients admitted with pancreatic trauma (0.6% of trauma admissions and 3.4% of abdominal injury admissions) with a mean age of 31 years. Sixty-two patients had pancreatic injury grade I-II and 9 had grade III-IV. Thirty-eight percent had GCS <9 and 73% had ISS >16. The level of pancreatic enzymes was significantly proportional to the grade of injury. Over half of patients required a laparotomy, of them 12 patients had an intervention on the pancreas. Eight patients developed complications related to pancreatic injuries ranging from pancreatitis to pancreatico-cutaneous fistula while 35% developed hemorrhagic shock. Mortality was 31% and regardless of the grade of injury, the mortality was associated with high ISS, low GCS and presence of hemorrhagic shock. Conclusion: Pancreatic injuries following blunt trauma are rare and the injured subjects are usually young male. However, most injuries are of low-grade severity. This study shows that shock, higher ISS and lower GCS are associated with worse in-hospital out-comes. Non-operative management may suffice in patients with lower grade injuries, which may not be the case in patients with higher grade injuries unless carefully selected

Keywords

trauma; pancreas; abdominal injury; head injury; polytrauma

Subject

Medicine and Pharmacology, Immunology and Allergy

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