外傷性すい損傷症例の検討

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  • A STUDY ON CASES OF TRAUMATIC PANCREAS INJURY

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A retrospective study on the diagnosis and treatment for pancreatic trauma was carried out. From 1994 to 2001, a total of 13 cases of pancreatic trauma were treated that represented 5.9% of all cases of abdominal trauma in the hospital. Twelve cases of them were of blunt injury, and nine (69.2%) of them were of traffic accident. Eleven cases (84.6%) of them had other organ injuries, and the liver (seven cases; 53.8%) was the most frequently injured organ. Diagnosis was mede by present illness, abdominal physical findings, the change in serum amylase level and CT findings. Among them, the sequential elevation in serum amylase level was useful for making the diagnosis, and positive rate of abdominal CT findings was 53.8%. Six patients were treated conservatively, the other seven were operated on, and one patient died of hypovolemic shock before converting to operation. Postoperative complications occurred in three (42.9%), but all of them were treated conservatively and we had no postoperative death.<br>We think that the precise pre-and intra-operative estimation of injured type of pancreas, best selection of operative procedure according to the patient's general condition and local findings, and adequate postoperative management are important for patients with traumatic pancreas injury.

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