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Pancreatic Trauma, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Direct epigastric blow compressing pancreas against vertebral column resulting in blunt trauma

  • Injury to pancreas from penetrating object

  • Trauma affects proportionately larger areas, l...

Diagnosis

Extent of pancreatic injury may not be apparent on initial evaluation. 

Signs and Symptoms

  • Abdominal pain:

    • Diffuse or epigastric

    • Often out of proportion to physical exam and vital signs

  • Soft-tiss...

Treatment

Pre-Hospital

Transport to closest trauma center. 

Initial Stabilization/Therapy

  • Airway management, resuscitation as indicated with crystalloids, colloids, or blood products

  • Nasogastric-tube suct...

Follow-Up

Disposition

Admission Criteria

  • All patients with suspected pancreatic injuries must be admitted.

  • Abdominal pain after blunt trauma requires serial exam and observation for 24–72 hr.

  • Intoxicated ...

Pearls and Pitfalls

  • Always consider pancreatic injury when evaluating abdominal or back trauma, both blunt and penetrating.

  • Beware of nearby vascular injuries.

  • Assess for related injuries.

  • Choose the bes...

Additional Reading

  • Ahmed  N, Vernick  JJ. Pancreatic injury. South Med J.  2009;102(12):1253–1256.

  • Almaramhy  HH, Guraya  SY. Computed tomography for pancreatic injuries in pediatric blunt abdomin...

Codes

ICD9

  • 863.84 Injury to pancreas, multiple and unspecified sites, without mention of open wound into cavity

  • 863.94 Injury to pancreas, multiple and unspecified sites, with open wound into cavity

ICD10

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