Traumatic pancreatic injuries and treatment outcomes: An observational retrospective study from a high-volume tertiary trauma center

Lindsey A Braden; Rebecca Minas-Alexander; Alexis Love; Essam Hashem; Philip Karuman; Amber L Jones

doi:10.1016/j.amjsurg.2024.116142

Traumatic pancreatic injuries and treatment outcomes: An observational retrospective study from a high-volume tertiary trauma center

Am J Surg. 2024 Dec 10:116142. doi: 10.1016/j.amjsurg.2024.116142. Online ahead of print.

Authors

Lindsey A Braden¹, Rebecca Minas-Alexander², Alexis Love³, Essam Hashem⁴, Philip Karuman⁵, Amber L Jones⁶

Affiliations

¹ Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA; Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA, 90509, USA. Electronic address: [email protected].
² Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA; Loma Linda University, School of Medicine, 11175 Campus St, Loma Linda, CA, 92350, USA. Electronic address: [email protected].
³ Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA. Electronic address: [email protected].
⁴ Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA. Electronic address: [email protected].
⁵ Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA. Electronic address: [email protected].
⁶ Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, 1700 Mount Vernon Ave, Bakersfield, CA, 93306, USA. Electronic address: [email protected].

PMID: 39690091
DOI: 10.1016/j.amjsurg.2024.116142

Abstract

Introduction: This study discusses a tertiary trauma center's experience involving traumatic pancreatic injuries, focusing on identification, management, and complications, aiming to provide a valuable contribution to the literature on pancreatic trauma management.

Methods: We conducted a five year (2019-2023) retrospective analysis utilizing trauma registry data to identified pancreatic injuries in tier 1 and 2 activations. Pancreatic Organ Injury Scaling (OIS) and overall injury severity (ISS) was assessed using AAST scoring. Data was stratified by mechanism, management, associated injuries, and outcomes.

Results: Thirty-one patients suffering firearm (48.4 %), stabbing (16.1 %), or blunt injuries (35.5 %) were investigated. Firearms correlated with diaphragm (P = 0.047), stomach (P = 0.001) and intrabdominal injury count (P = 0.0042). Robust trends were found between OIS, ISS, complication, mortality and many alike.

Conclusion: In penetrating injury, increasing ISS and number of intrabdominal injuries should heighten pancreatic trauma suspicion and lower the threshold for surgical exploration, particularly when involving the diaphragm, stomach, transverse colon or spleen.

Keywords: Abdominal trauma; Pancreatic duct injury; Pancreatic trauma; Penetrating injury.