Injuries to the Pancreaticoduodenal Complex

Abstract

Injuries to the pancreaticoduodenal complex present a significant challenge both in diagnosis and management. The retroperitoneal location of the pancreas means that it is not a common site of injury, but this also contributes to the difficulty in diagnosis, as the organ is concealed, and investigation often results in delay with its attendant increase in morbidity. The increase in violence in society, particularly of penetrating injuries and the increase in energy of wounding from gunshots, has made pancreatic injury more common. In many cases the surgical management is relatively simple, but occasionally complex and technical surgical solutions are necessary and the position of the pancreas makes its access and all procedures on it challenging. To compound this, pancreatic trauma is associated with a high incidence of injury to adjoining organs and major vascular structures, which adds to the high morbidity and mortality, and complications occur in 30-60% of patients [1, 2].

Focus on Solid Organ Injury

“…Any delay can mean death and ideal treatment requires optimal interdisciplinary cooperation. Other subjects of interest in this issue are the liver [5], pancreas [6] and spleen [7] as frequent sites of intraabdominal injury. Liver and spleen trauma are increasingly treated non-surgically; indications and criteria for such treatment have changed with increasing experience and undergone further development.…”