The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

We undertook a retrospective review of all blunt trauma patients admitted to the Chi-Mei Medical Center from January 2004 to June 2006. Every patients underwent abdominal CT scan in emergency department and the CT scans were obtained with a four-slice helical CT. Diagnosis of a pancreatic injury in these patients was by surgical observation or by CT findings. Radiographic pancreatic injuries were classified as deep or superficial lesions. Deep lesions were defined as the hematomas or lacerations >50% thickness of the pancreas. Superficial lesions were described as the hematomas or lacerations <50% thickness of the pancreas; pancreatic edema; and focal fluid accumulation around the pancreasNineteen patients with pancreatic trauma, fourteen males and five females, average age 40.6 ± 21.4 years, were included. Most patients (73.7%) with pancreatic trauma had associated organ injuries. CT was performed in all patients and laparotomy in 14 patients. CT was 78.9% sensitive in detecting pancreatic trauma. All deep pancreatic lesions revealed on CT required surgical treatment, and complication was discovered in two patients undergoing delayed surgery. Superficial lesions were managed conservatively.Four-slice helical CT can detect most pancreatic trauma and provide practical therapeutic guidance. Delayed operation might result in complications and is associated with prolonged hospital stays.Pancreatic trauma is uncommon and most trauma surgeons have little experience in managing the condition [1,2]. To complicated matters, most patients with pancreatic trauma have concomitant injuries, [2] which frequently obscure the symptoms of pancreatic trauma and distract the attention of the trauma surgeon. Serum amylase and lipase tests have been proved neither sensitive nor specific [3,4]. Moreover, the pancreas is deeply seated in the retroperitoneum and there are difficulties using physical examination, sonography and diagnostic peritoneal lavage to investigate this area [1,5,6].T