Abstract

Since the first pancreatic injury was reported by Traverse in 1827, the pancreatic trauma has been reported with increasing frequency due to high speed automobile accidents and other acts of violences. The morbidity and mortality of the pancreatic injuries reported in the literatures varied 30 to 50 per-cent and 10 to 32 percent respectively. In an effort to improve the results of management of patients with pancreatic injuries, authors analyed the records of twenty-nine patients with acute pancreatic injury and six patients with traumatic pan-creatic pseudocyst, who were treated at the Department of Surgery, College of Medicine, Yonsei University, over the past 7 years. The results were as follows: 1. The sex distribution was 30 males and 5 females, 29 among the were between 16 and 45 years of age. 2. Thirty-four cases were by blunt abdominal trauma and one was by stab injury. 3. The traumatic pseudocyst during the same period was six (17%). 4. The incidence requiring major pancreatic resection was sixteen cases (46%). 5. Associated injuries occurred in 12 cases (34%) and the injuried structures were duodenum, liver, small bowel and kidney in decreasing frequency. 6. The preoperative serum amylase was increased in 19 cases (54%) and it was not significant in the diagnosis of the traumatic pancreatic injuries. 7. The injured site of pancreas was 4 in the head, 6 in the neck, 10 in the body, 6 in the tail and 3 in the body and tail. 8. The operative management was simple drainage (7 cases), simple closure and drainage (6 cases), distal pancreatectomy (13 cases) and pancreaticoduodenectomy (3 cllses). 9. The postoperative complications were present in 8 cases (28%) in 29 acute pancreatic trauma; pan-creatic fistula (5), pseudocyst (4), pancreatic abscess (2) and colocutaneous fistula (1). But there was no mortality.