**6.6. Pancreas injuries**

Blunt pancreatic transection at the neck of the pancreas can occur with a direct blow to the abdomen. As an isolated injury, it is more difficult to detect than blunt duodenal rupture; however, a missed pancreatic injury is more benign [33]. Since the main pancreatic duct is transected, the patient will develop a pseudocyst or pancreatic ascites, but there is little inflammation since the pancreatic enzymes remain unactivated [34].

**References**

2001;**67**:364. [PMID: 11308006]

inal injuries. Advances in Surgery. 1999;**33**:243

Trauma. 2001;**51**:1134. [PMID: 11740265]

**201**(2):213-216. [PMID: 16038818]

2002;**52**(6):1134-1140. [PMID: 12045643]

[PMID: 10883989]

[PMID: 11893099]

2003;**55**:1095

(review)

Surgical Techniques. Part A. 2001;**11**:207. [PMID: 11569509]

[1] Gracias VH et al. Defining the learning curve for the focused abdominal sonogram for trauma (FAST) examination: Implications for credentialing. The American Surgeon.

Abdominal Trauma

91

http://dx.doi.org/10.5772/intechopen.76474

[2] Rozycki GS, Newman PG. Surgeon-performed ultrasound for the assessment of abdom-

[3] Gonzales RP et al. Abdominal stab wounds: Diagnostic peritoneal lavage criteria for emergency room discharge. The Journal of Trauma. 2001;**51**:939. [PMID: 11706344] [4] Gonzales RP, Ickler J, Gachassin P. Complemantary roles of diagnostic peritoneal lavage and computed tomography in the evaluation of blunt trauma patients. The Journal of

[5] Taner AS et al. Diagnostic laparoscopy decreases the rate of unnecessary laparotemies and reduces hospital costs in trauma patients. Journal of Laparoendoscopic & Advanced

[6] Ahmed N, Whelan J, Brownlee, et al. The contribution of laparoscopy in evaluation of penetrating abdominal wounds. Journal of the American College of Surgeons. 2005;

[7] DeMaria EJ et al. Complementary roles of laparoscopy abdominal exploration and diagnostic peritoneal lavage for evaluating abdominal stab wounds: A prospective study. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A. 2000;**10**:131.

[8] Ng AK, Simons RK, Torreggiani WC. Intra-abdominal free fluid without solid organ injury in blunt abdominal trauma: An indication for laparotomy. The Journal of Trauma.

[9] Albrecht RM, Schermer CR, Morris A. Nonoperative management of blunt splenic injuries: Factors influencing success in age>55 years. The American Surgeon. 2002;**68**:227.

[10] Pepe PE, Mosesso VN, Falk JL. Prehospital fluid resuscitation of the patient with major

[11] Armenakas NA, Duckett CP, McAninch JW. Indications for nonoperative management

[12] Nicholas JM et al. Changing patterns in the management of penetrating abdominal trauma: The more things change, the more they stay the same. The Journal of Trauma.

[13] Pryor JP, Reilly PM, Dabrowski GP, et al. Nonoperative management of abdominal gunshot wounds. Annals of Emergency Medicine. 2004;**43**(3):344-353. [PMID: 14985662]

trauma. Prehospital Emergency Care. 2002;**6**:81. [PMID: 11789657]

of renal stab wounds. The Journal of Urology. 1999;**161**:768

It is apparent that no ideal method exists for identifying pancreatic ductal injuries that cannot be ruled out by direct exploration [35].

Fortunately, majority of pancreatic fistulas will close spontaneously with only supportive care [36] (**Table 6**).
