Serum Amylase Level on Admission in the Diagnosis of Blunt Injury to the Pancreas

Takishima, T; Sugimoto, Katsuhiko; Hirata, Mitsuho; Asari, Yasushi; Ohwada, Takashi; Kakita, Akira

doi:10.1097/00000658-199707000-00010

Cited by 143 publications

(67 citation statements)

References 18 publications

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“…There are limitations regarding the use of serum amylase to diagnose pancreatic trauma because it can be negative in early stages of less than 3 hours after the injury 22 . Furthermore, it may be raised without serious abdominal injuries.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Abu‐Zidan

Af²,

Mousa³

et al. 2013

Afr H. Sci.

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Background: Human pancreatico-duodenal injuries caused by camels are extremely rare. Objective: We report three patients who sustained camel-related pancreatico-duodenal injuries and review the literature on this topic. Results: A 32-year camel caregiver was kicked by a camel which then stepped on his abdomen trying to kill him. The patient's abdomen was soft and lax. CT scan of the abdomen showed free retroperitoneal air. Laparotomy revealed a complete tear of the anterior wall of the second part of duodenum which was primarily repaired. A 40-year camel caregiver was directly kicked into his abdomen by a camel. He developed traumatic pancreatitis which was treated conservatively. A 31-year-old male fell down on his abdomen while riding a camel. Abdominal examination revealed tenderness and guarding. Abdominal CT Scan showed complete transection of the neck of the pancreas which was confirmed by laparotomy. The patient had distal pancreatectomy with preservation of the spleen. All patients were discharged home in good condition.Conclusion: These cases demonstrate the misleading presentation of the camel-realted pancreatico-duodenal injuries and their unique mechanism of injury.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, our second patient presented after 24 hours of the injury. The most important factor that affects the serum amylase level on admission is the elapsed time from injury to admission 22 . About 70% of the patients who have pancreatic injuries will have raised serum amylase on admission 3,23 .…”

Section: Discussionmentioning

confidence: 99%

Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Abu‐Zidan

Af²,

Mousa³

et al. 2013

Afr H. Sci.

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“…9 Serial or delayed serum amylase levels have been more useful. 10 Helical contrast-enhanced CT scan is the initial imaging study of choice for detection of pancreatic injury in a stable patient. Reported sensitivity and specificity rates are as high as 90%, Some of the CT findings suggestive of pancreatic injuries include peri-pancreatic fluid in the lesser sac; pancreatic hematoma or laceration and focal edema at the site of the injury.…”

Section: Discussionmentioning

confidence: 99%

Blunt trauma pancreas

Santosh¹,

Thejas²,

Vijayakumar³

et al. 2013

Int J of Biomed & Adv Res

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The incidence of pancreatic injuries after blunt abdominal trauma is very low, with rates of less than 1% quoted for all trauma admissions. Major injuries of the pancreas are uncommon, but may

result in considerable morbidity and mortality. Due to retroperitoneal location of the organ, symptoms and signs of pancreatic trauma are subtle making diagnosis more difficult and easily missed. Assessment of the injury includes determining the degree of parenchymal involvement , location of injury within the gland and presence of pancreatic ductal involvement. When a pancreatic injury is identified, the method of management is determined by the condition of the patient, the severity of injury and anatomic location. Successful treatment of complex injuries of the pancreas depends largely on initial correct assessment and appropriate treatment. The management of the severe pancreatic injuries remains one of the most difficult challenges in abdominal trauma management.

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“…The limits of this examination in defining the presence and gravity of pancreas trauma are well known. It was reported that the sensitivity of pancreatic rupture is 42.9% [6,10,11] and its low accuracy is particularly critical in defining the damage of the main pancreatic duct, the single most important factor both for surgical indication and choice of the best surgical strategy [12][13][14] . In our case, CT allowed to exclude thoracic lesions and to focus on the pancreatic region, demonstrating the pancreatic body fracture and the presence of associated vascular damage.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic transection from blunt trauma associated with vascular and biliary lesions: A case report

Baiocchi¹,

Tiberio²,

Gheza³

et al. 2008

WJG

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M a j o r i n j u r i e s o f t h e p a n c re a s m ay re s u l t i n considerable morbidity and mortality when associated with vascular and visceral injuries. In such cases, a right diagnosis and a prompt surgical intervention are necessary to give a chance to the patient. We herein describe a case of blunt abdominal trauma in a 29-yearold man whose pancreatic rupture was associated with hepatic artery, splenic vein and extrahepatic bile duct damage. Immediate surgery was performed after computer tomography (CT), the haemorrhagic lesions dictate the emergency transfer to the operating room. Spleno-pancreatic resection was done with reconstruction of the hepatic artery, ligation of the splenic vein and a Roux-en-Y bilio-jejunal diversion. The early post-operative course was complicated by stenosis of the arterial reconstruction, which was treated by endovascular angioplasty followed by percutaneous drainage of symptomatic pseudocyst, rest and antibiotics. Finally, the patient was discharged and was alive without clinical problems at the time when we wrote this case report. The present case underlines the clinical relevance of vascular and visceral injuries associated with pancreatic trauma and the problems arising in the diagnostic evaluation and the surgical strategy of complex multiple visceral and vascular lesions in blunt abdominal trauma.

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Serum Amylase Level on Admission in the Diagnosis of Blunt Injury to the Pancreas

Abstract: To avoid failure in the detection of pancreatic injury, the authors advocate determination of serum amylase levels more than 3 hours after trauma.

Cited by 143 publications

References 18 publications

Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Blunt trauma pancreas

Pancreatic transection from blunt trauma associated with vascular and biliary lesions: A case report

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