Associated organ injuries in pancreatic injuries, morbidity, and mortality

Authors: AKIN ÖNDER, METEHAN GÜMÜŞ, MURAT KAPAN, ABDULLAH BÖYÜK, ZÜLFÜ ARIKANOĞLU, SADULLAH GİRGİN

Abstract: Aim: Pancreatic injuries are rarely seen due to the retroperitoneal location of the organ. Associated organ and vascular structures usually accompany injury. In this study, the effect of ductal injury and associated organ injuries on morbidity and mortality was investigated. Materials and methods: Between January 2004 and October 2010, 26 patients with abdominal trauma who developed pancreatic injury and underwent surgery at the Dicle University General Surgery Department were evaluated retrospectively. Results: Of the 26 patients, 20 were males (76.9%) and 6 (23.1%) were females. The mean age of the patients was 24.96 ± 9.4 (14-56) years. Of the injuries, 21 (80.8%) were related to penetrating trauma and 5 (19.2%) were related to blunt trauma. Of the patients, 6 (23.1%) were stage I, 12 (46.2%) were stage II, 5 (19.2%) were stage III, and 3 (11.5%) were stage IV The most commonly injured associated organs were the stomach (50%) and vascular structures. Eighteen patients underwent primary suturing, 5 underwent distal pancreatectomy, 3 underwent Roux-en-Y pancreaticojejunostomy., Common postoperative complications included intraabdominal abscess and pancreatic fistula. Mortality occurred in 3 (11.5%) patients, 2 of them due to hemorrhagic shock resulting from vascular injury and 1 of them as a result of fistula-induced sepsis and multi-organ failure. Conclusion: A good exploration should be done in all abdominal traumas, remembering that pancreatic injury could occur. Mortality may increase during the early period in patients who have vascular injuries. Morbidity and late mortality may increase in patients with ductal injuries.

Keywords: Pancreatic ductal injury, associated organ injury, morbidity, mortality

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