Diagnosis and treatment of traumatic pancreatitis
10.3877/cma.j.issn.2095-3232.2016.06.005
- VernacularTitle:创伤性胰腺炎的诊断与治疗
- Author:
Zhongjie ZHAO
1
;
Bei SUN
;
Xuewei BAI
;
Hua CHEN
;
Le LI
Author Information
1. 150001,哈尔滨医科大学附属第一医院胰胆外科
- Keywords:
Wounds and injuries;
Pancreatitis;
Diagnosis;
Therapeutics
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(6):358-362
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of diagnosis and treatment of traumatic pancreatitis (TP). Methods Clinical data of 13 patients with TP who were admitted to the First Affiliated Hospital of Harbin Medical University between October 2013 and October 2015 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 9 males and 4 females, aged from 28 to 53 years old with a median age of 39 years old. All patients had a definite medical history of trauma, mainly traffic and crush injury. The diagnosis, treatment and complications of the patients were observed. Results The patients were mainly with gradeⅡ and Ⅲ pancreatic damage, incluing 5 cases of pancreatic head injury and 8 of pancreatic neck, body and tail injury. Most patients were diagnosed with TP on 2-5 d after trauma. One case received non-surgical treatment. Twelve cases underwent minimally invasive surgery, including 8 cases treated with percutaneous catheter drainage, 1 with endoscopic pancreatic stent, 4 with endoscopic removal of necrotic tissue. Eight cases underwent laparotomy. Complications were observed in 12 cases. Nine cases developed abdominal or retroperitoneal infection and underwent minimally invasive surgery. Among them, 6 cases were complicated with severe multiple organ injuries and underwent re-operation. Five cases suffered colonic fistula. Among them, colonic fistula of 3 cases were interlinked with abdominal infectious focals, and they underwent fistula proximal intestinal colostomy and two-stage fistula closure. The median length of hospital stay was 57(17-134) d. All patients were recovered and discharged after treatment. Conclusions It is difficult to make an early diagnosis of TP due to the insidious onset and rapid progression. Individualized treatment should be chosen according to the specific conditions of patients.
