INTRODUCTION: Pancreatoduodenal (PD) injury is an uncommon but serious complication of blunt and penetrating trauma, associated with high mortality. The aim of this study was to assess the incidence, mechanisms of injury, initial operation rates and outcome of patients who sustained PD trauma in the UK from a large trauma registry, over the period 1989-2013. METHODS: The Trauma Audit and Research Network database was searched for details of any patient with blunt or penetrating trauma to the pancreas, duodenum or both. RESULTS: Of 356,534 trauma cases, 1,155 (0.32%) sustained PD trauma. The median patient age was 27 years for blunt trauma and 27.5 years for penetrating trauma. The male-to-female ratio was 2.5:1. Blunt trauma was the most common type of injury seen, with a ratio of blunt-to-penetrating PD injury ratio of 3.6:1. Road traffic collision was the most common mechanism of injury, accounting for 673 cases (58.3%). The median injury severity score (ISS) was 25 (IQR: 14-35) for blunt trauma and 14 (IQR: 9-18) for penetrating trauma. The mortality rate for blunt PD trauma was 17.6%; it was 12.2% for penetrating PD trauma. Variables predicting mortality after pancreatic trauma were increasing age, ISS, haemodynamic compromise and not having undergone an operation. CONCLUSIONS: Isolated pancreatic injuries are uncommon; most coexist with other injuries. In the UK, a high proportion of cases are due to blunt trauma, which differs from US and South African series. Mortality is high in the UK but comparison with other surgical series is difficult because of selection bias in their datasets.
INTRODUCTION:Pancreatoduodenal (PD) injury is an uncommon but serious complication of blunt and penetrating trauma, associated with high mortality. The aim of this study was to assess the incidence, mechanisms of injury, initial operation rates and outcome of patients who sustained PD trauma in the UK from a large trauma registry, over the period 1989-2013. METHODS: The Trauma Audit and Research Network database was searched for details of any patient with blunt or penetrating trauma to the pancreas, duodenum or both. RESULTS: Of 356,534 trauma cases, 1,155 (0.32%) sustained PD trauma. The median patient age was 27 years for blunt trauma and 27.5 years for penetrating trauma. The male-to-female ratio was 2.5:1. Blunt trauma was the most common type of injury seen, with a ratio of blunt-to-penetrating PD injury ratio of 3.6:1. Road traffic collision was the most common mechanism of injury, accounting for 673 cases (58.3%). The median injury severity score (ISS) was 25 (IQR: 14-35) for blunt trauma and 14 (IQR: 9-18) for penetrating trauma. The mortality rate for blunt PD trauma was 17.6%; it was 12.2% for penetrating PD trauma. Variables predicting mortality after pancreatic trauma were increasing age, ISS, haemodynamic compromise and not having undergone an operation. CONCLUSIONS: Isolated pancreatic injuries are uncommon; most coexist with other injuries. In the UK, a high proportion of cases are due to blunt trauma, which differs from US and South African series. Mortality is high in the UK but comparison with other surgical series is difficult because of selection bias in their datasets.
Authors: E E Moore; T H Cogbill; M A Malangoni; G J Jurkovich; H R Champion; T A Gennarelli; J W McAninch; H L Pachter; S R Shackford; P G Trafton Journal: J Trauma Date: 1990-11
Authors: Herb A Phelan; George C Velmahos; Gregory J Jurkovich; Randall S Friese; Joseph P Minei; Jay A Menaker; Allan Philp; Heather L Evans; Martin L Gunn; Alexander L Eastman; Susan E Rowell; Carrie E Allison; Ronald L Barbosa; Scott H Norwood; Malek Tabbara; Christopher J Dente; Matthew M Carrick; Matthew J Wall; Jim Feeney; Patrick J O'Neill; Gujjarappa Srinivas; Carlos V R Brown; Andrew C Reifsnyder; Moustafa O Hassan; Scott Albert; Jose L Pascual; Michelle Strong; Forrest O Moore; David A Spain; Mary-Anne Purtill; Byard Edwards; Jason Strauss; Rodney M Durham; Juan C Duchesne; Patrick Greiffenstein; C Clay Cothren Journal: J Trauma Date: 2009-03
Authors: Micah G Katz; Stephen J Fenton; Kathryn W Russell; Eric R Scaife; Scott S Short Journal: Pediatr Surg Int Date: 2018-04-05 Impact factor: 1.827
Authors: Poppy Addison; Toni Iurcotta; Leo I Amodu; Geoffrey Crandall; Meredith Akerman; Daniel Galvin; Annemarie Glazer; Nathan Christopherson; Jose Prince; Matthew Bank; Christopher Sorrentino; Joaquin Cagliani; Jeffrey Nicastro; Gene Coppa; Ernesto P Molmenti; Horacio L Rodriguez Rilo Journal: Burns Trauma Date: 2016-12-09
Authors: J Barrie; S Jamdar; M F Iniguez; O Bouamra; T Jenks; F Lecky; D A O'Reilly Journal: Eur J Trauma Emerg Surg Date: 2017-02-16 Impact factor: 3.693
Authors: Federico Coccolini; Leslie Kobayashi; Yoram Kluger; Ernest E Moore; Luca Ansaloni; Walt Biffl; Ari Leppaniemi; Goran Augustin; Viktor Reva; Imitiaz Wani; Andrew Kirkpatrick; Fikri Abu-Zidan; Enrico Cicuttin; Gustavo Pereira Fraga; Carlos Ordonez; Emmanuil Pikoulis; Maria Grazia Sibilla; Ron Maier; Yosuke Matsumura; Peter T Masiakos; Vladimir Khokha; Alain Chichom Mefire; Rao Ivatury; Francesco Favi; Vassil Manchev; Massimo Sartelli; Fernando Machado; Junichi Matsumoto; Massimo Chiarugi; Catherine Arvieux; Fausto Catena; Raul Coimbra Journal: World J Emerg Surg Date: 2019-12-11 Impact factor: 5.469