Pancreatic trauma

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Introduction The pancreatic lesion is a very infrequent finding after a closed abdominal tramautism with a rate of complications that affects 30-40% of patients and mortality that could rteach 39%. 1-4 It is considered that only around 5% of closed abdominal traumatisms affect the pancreatic gland.1 The disgnostic suspicion is noramlyy late due to the unspecificity of the clinical symptoms.5 The computerised tomography (CT), with some limitations, is the imaging test of choice in the diagnosis and cáncer staging in the acute phase..6 The complete section of the Wirsung conduct, which occurs in 15-30%, is an indication of urgent surgical treatment.1,2 According to our experience, the closed abdominal traumatisms produced in the practice of typical popular horse-riding festivals in our regiuon (Figura 1) constitute a high risk of pancreatic traumatism.7 The objective is riase awareness of our experience in the diagnosis and treatment of pancreatic lesion secondary to closed abdominal traumatism. Case report CASE 1 Female of 15 years without any clinical background of interest, who suffered closed abdominal traumatism secondary to a fall from a horse and abdmoinal crushing came to n Hospital Mateu Orfila in Menorca. On examination she presented abdominal pain and hemodynamic instability. A FAST (Focused Abdominal Sonography for Trauma) abdmonial ultrasound was performed where free liquid was observed at a subhepatic and perisplenic level, which indicated an urgent laparotomy. The intraoperative findings showed scarce hemoperiteneal and small hepatic laceration in segment 3 that was treated by electrocoagulation. During the immediate pòstoperative a cxlinical improvement was not seen and high levels of amylase in the srum were ... ... middle of paper ... ...here we expose there were no intraoperative or early postoperative complications . Followed for 18 and 7 months respectively in each case after surgery have not been reflected in the digestive and glucose metabolism disorders. The two most important determinants of prognosis are the state of the main pancreatic duct and the time from injury to treatment definitivo.11 In conclusion, the identification of a pancreatic injury after blunt abdominal trauma requires a high index of suspicion based on the mechanism of injury . Riding in the context of regional parties in our environment is a risk factor . A safer option may be the distal pancreatic anastomosis pancreáticogástrica preservation with grade III lesions without deadening the distal pancreas. Seems warranted further studies with larger series to establish a greater degree of evidence for this surgical technique.

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