Management of pancreatic trauma in urban India: A multicenter study

Background: Pancreatic trauma occurs in 0.2-2% of patients with blunt trauma and 1-12% of patients with penetrating trauma. The mortality and morbidity rates range from 9 to 34% and 30-60% respectively. We aimed to review the management of pancreatic trauma in a multicenter database from India.

Methods: We analyzed all patients who suffered a pancreatic injury and who were included in the multicenter prospective observational study 'Towards Improved Trauma Care Outcomes (TITCO)'.

Results: Of the 16047 trauma cases, 1134 (7.1%) patients suffered abdominal trauma. Of all those with abdominal trauma, 55 patients (4.9%) had injury to the pancreas. 28 patients (50.9%) with pancreatic trauma were managed conservatively. 27 patients (49.1%) underwent surgical exploration in the form of laparotomies. 11 procedures were undertaken for pancreas. A total of 45 (82%) patients had associated injuries along with pancreatic injury. Thorax (19) (including injuries to lung, pleura and ribs), liver (17), bowel (14) and spleen (13) were the most common associated injuries.

Conclusion: Conservative management was as common as operative management in patients with pancreatic injuries. Most (80%) grade III/IV underwent operative treatment. Many patients (82%) had associated injuries.

Level of evidence: III.