Imaging abdomen trauma pancreatic trauma part 4 Dr Ahmed Esawy

PANCREATIC INJURY

It is relatively uncommon being encountered in

around 3 % of abdominal trauma, usually caused by

blunt trauma.

FAST has a limit role in acute pancreatic injury.

CT is the most reliable imaging modality.

MRCP is useful in evaluating PD disruption and

associated fluid collection.

CT Findings In Pancreatic Injury

Thickened anterior pancreatic fascia and fluid in the

lesser sac.

Fluid rim between pancreas and splenic vein.

Focal pancreatic contusion and hematoma.

Pancreatic Laceration

PANCREATIC TRAUMA

PANCREATIC TRAUMA

A CT scan performed after abdominal trauma showing diffuse pancreatic

enlargement and was interpreted as suspicious for pancreatic injury. (Grade 1

injury).

Follow-up CT scan 3 days after abdominal trauma

revealing a tear of the pancreatic body.

A CT scan performed 7 months after surgery showing the

presence of a pseudocyst adjacent to the point of injury

Laceration of the

pancreatic neck without

duct injury

Pancreatic transection (neck)

with duct injury

Subtle pancreatic contusion

Indirect Signs • Edema with global pancreatic enlargement and

loss of lobulation

• Peripancreatic fat infiltration

• Peripancreatic fluid, especially if it is located

around the SMA or the omental bursa

• Hematic fluid between the dorsal surface of the

pancreas and the splenic vein

• Thickening of the left anterior pararenal fascia or

fluid in the anterior pararenal space

• Concomitant duodenal injury

Serum amylase, hematocrit and hemoglobin values during

the initial three days after abdominal trauma.

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