Case series: Management and outcomes of five cases of blunt and open pancreatic trauma

Abstract

Introduction Pancreatic trauma is notably less frequent than injuries affecting other solid organs, such as the liver or spleen. Despite their infrequency, pancreatic injuries can pose significant risks, with mortality rates ranging from 5 to 30% and morbidity rates reaching 50%. Managing such injuries remains contentious because of the anatomical complexity, lesion extent, and close proximity to neighboring organs. Methods Our study aimed to delineate the clinical and biological characteristics of pancreatic trauma and specify diagnostic and therapeutic modalities. This study was conducted retrospectively from 2010 to 2021 at Mahmoud El Matri Hospital’s General Surgery Department in Ariana, TUNISIA, and included five cases of blunt and open pancreatic trauma. Results Although rare, pancreatic injuries can lead to serious consequences, prompting the development of a diverse array of therapeutic options. Pancreatic trauma presents a complex clinical challenge, necessitating a comprehensive approach that considers various factors, such as injury severity, anatomical location, and patient condition. Advanced imaging techniques, including computed tomography (CT) scanning, Wirsung-MRI, and ERCP, aid in the accurate diagnosis and assessment of canal involvement. Conservative management was considered for cases with limited canal rupture, whereas endoscopic treatments showed promise for hemodynamically stable cases. Surgical interventions, such as duodenopancreatectomy, are reserved for exceptional cases with severe injuries. Conclusion Pancreatic trauma requires a comprehensive approach that considers factors such as injury severity, anatomical location, and patient condition. Ongoing research and collaboration are vital for refining pancreatic trauma management and proposing guidelines for facilitating decision-making.