BACKGROUND: Pancreatic lesion is uncommon after closed or penetrating abdominal trauma, being related between 0,2 to 12% in severe closed abdominal traumas and in 5 to 7% of penetrating traumas. The majority of pancreatic lesions occur in young men and is associated with an increased incidence of trauma in adjacent organs and major vascular structures. AIM: To evaluate morbimortality rates, evolution and handling of patients with pancreatic trauma. METHODS: A prospective study of patients admitted to the trauma unit was made. Thirteen adults (>13 years-old) were divided into two groups one composed of severe and the other composed of non-severe patients according to clinical criterion in the moment of identification of trauma using the Balthazars' criteria (A, B, C, D and E). The type of external trauma (opened or closed), classification of pancreatic trauma, number of organs reached by trauma, number of reoperations, type of nutritional support and period of time in the hospital were also analyzed. Presence of compartmental abdominal syndrome and necessity to close trauma temporarily were studied and compared to morbimortality in patients. RESULTS: All patients were male, with an average age of 28,6 years (13 to 60 years of age), presenting postoperatory traumatic pancreatitis. Seven patients, showed penetrating wounds due to firearms; three had closed abdomen; two had knife wounds and one had severe burns (> 50% of body area). Trauma classification showed, I and II degree in 38,46%; III degree in 15,38% and IV degree in 7,7% of patients. Pancreatic drainage, lesion hemostasia and distal pacreactomy with splenectomy associated with cavity drainage were performed. Eight patients were classified as non-severe. According to Balthazars' criteria, grades D and C were predominant, with four patients each. There were no grade A patients and only one was grade E. Only three patients were reoperated (average of 1,7 surgeries per patients). In 46,15% intra-abdominal hypertension occurred, making it necessary to apply the Bogota bag procedure. The period of admission varied between 30 to 365 days (average of 53,4 days). Only one death was registered. CONCLUSIONS: Pancreatitis due to trauma has elevated morbimortality rates and is one of the most significant complications related to pancreatic trauma. Consequently early diagnoses along with intensive multidisciplinary follow-up are important and determinant factors which directly interfere in a favorable evolution of these patients.
Pancreatitis; Pancreas, injury; Mortality
