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The Surgical Significance of Trauma to the Pancreas

The Surgical Significance of Trauma to the Pancreas Abstract Introduction Pancreatic trauma has long been a neglected realm in abdominal injury, largely because the pancreas has been considered to be a friable, relatively inaccessible, and highly hazardous structure with which to work. Nevertheless, as trauma assumes an increasingly important role in surgery, some valuable therapeutic principles have emerged.Few reports of substantial series of nonoperative pancreatic injury have appeared until recently. With high-speed travel and the resultant injuries continually increasing, greater emphasis is being placed on salvage of patients with severe and, frequently, multiple injuries.The pancreas occupies an unfortunate position, for the patient and the surgeon, being centrally placed and overlying the relatively rigid aorta and vertebral column. A force striking the abdomen anteriorly may directly tear or fracture the gland, or a contrecoup injury may result. Injury is more likely to occur if the force strikes the relaxed abdomen, or if the patient is unconscious.Penetrating wounds References 1. Letton, A. H., and Wilson, J. P.: Traumatic Severance of the Pancreas Treated by Roux-Y Anastomosis , Surg Gynec Obstet 109:473-478, 1959. 2. Kerry, R. L., and Glas, W. W.: Traumatic Injuries of the Pancreas and Duodenum , Arch Surg 85:813-816, 1962.Crossref 3. Fogelman, M. J., and Robison, L. J.: Wounds of the Pancreas , Amer J Surg 101:698-706, 1961.Crossref 4. Doubilet, A., and Mulholland, J. H.: Surgical Management of Injury to the Pancreas , Ann Surg 150:854-863, 1959.Crossref 5. Blandy, J. P.; Hamblen, D. L.; and Kerr, W. F.: Isolated Injury of the Pancreas From Non-Penetrating Abdominal Trauma , Brit J Surg 47: 150-155, 1959.Crossref 6. Hannon, D. W., and Sprafka, J.: Resection for Traumatic Pancreatitis , Ann Surg 146:136-138, 1957.Crossref 7. Becker, W. F.: Traumatic Pancreatitis , Amer Surg 20:525-532, 1954. 8. Pellegrini, J. N., and Stein, I. J.: Complete Severance of the Pancreas and Its Treatment With Repair of the Main Pancreatic Duct of Wirsung , Amer J Surg 101:707-710, 1961.Crossref 9. Bracey, D. W.: Complete Rupture of the Pancreas , Brit J Surg 48:575-576, 1961.Crossref 10. Ashmore, J. D.; Thomason, J. R.; Amspacher, W. H.; and Grimball, G. M.: Management of Traumatic Pancreatitis , Southern Med J 53:1423-1425, 1960.Crossref 11. Puestow, C. B.: " Pancreatic Trauma ," in Surgery of the Biliary Tract, Pancreas and Spleen , Chicago: Year Book Medical Publishers, Inc., 1955. 12. Mathewson, C., Jr., and Halter, B. L.: Traumatic Pancreatitis With and Without Associated Injuries , Amer J Surg 83:409-412, 1952.Crossref 13. Kinnaird, D. W.: Pancreatic Injuries Due to Non-Penetrating Abdominal Trauma , Amer J Surg 91:552-557, 1956.Crossref 14. Puestow, C. B., and Gillesby, W. J.: Retrograde Surgical Drainage of the Pancreas for Chronic Relapsing Pancreatitis , AMA Arch Surg 76:898-905, 1958.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Surgical Significance of Trauma to the Pancreas

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Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310120156022
Publisher site
See Article on Publisher Site

Abstract

Abstract Introduction Pancreatic trauma has long been a neglected realm in abdominal injury, largely because the pancreas has been considered to be a friable, relatively inaccessible, and highly hazardous structure with which to work. Nevertheless, as trauma assumes an increasingly important role in surgery, some valuable therapeutic principles have emerged.Few reports of substantial series of nonoperative pancreatic injury have appeared until recently. With high-speed travel and the resultant injuries continually increasing, greater emphasis is being placed on salvage of patients with severe and, frequently, multiple injuries.The pancreas occupies an unfortunate position, for the patient and the surgeon, being centrally placed and overlying the relatively rigid aorta and vertebral column. A force striking the abdomen anteriorly may directly tear or fracture the gland, or a contrecoup injury may result. Injury is more likely to occur if the force strikes the relaxed abdomen, or if the patient is unconscious.Penetrating wounds References 1. Letton, A. H., and Wilson, J. P.: Traumatic Severance of the Pancreas Treated by Roux-Y Anastomosis , Surg Gynec Obstet 109:473-478, 1959. 2. Kerry, R. L., and Glas, W. W.: Traumatic Injuries of the Pancreas and Duodenum , Arch Surg 85:813-816, 1962.Crossref 3. Fogelman, M. J., and Robison, L. J.: Wounds of the Pancreas , Amer J Surg 101:698-706, 1961.Crossref 4. Doubilet, A., and Mulholland, J. H.: Surgical Management of Injury to the Pancreas , Ann Surg 150:854-863, 1959.Crossref 5. Blandy, J. P.; Hamblen, D. L.; and Kerr, W. F.: Isolated Injury of the Pancreas From Non-Penetrating Abdominal Trauma , Brit J Surg 47: 150-155, 1959.Crossref 6. Hannon, D. W., and Sprafka, J.: Resection for Traumatic Pancreatitis , Ann Surg 146:136-138, 1957.Crossref 7. Becker, W. F.: Traumatic Pancreatitis , Amer Surg 20:525-532, 1954. 8. Pellegrini, J. N., and Stein, I. J.: Complete Severance of the Pancreas and Its Treatment With Repair of the Main Pancreatic Duct of Wirsung , Amer J Surg 101:707-710, 1961.Crossref 9. Bracey, D. W.: Complete Rupture of the Pancreas , Brit J Surg 48:575-576, 1961.Crossref 10. Ashmore, J. D.; Thomason, J. R.; Amspacher, W. H.; and Grimball, G. M.: Management of Traumatic Pancreatitis , Southern Med J 53:1423-1425, 1960.Crossref 11. Puestow, C. B.: " Pancreatic Trauma ," in Surgery of the Biliary Tract, Pancreas and Spleen , Chicago: Year Book Medical Publishers, Inc., 1955. 12. Mathewson, C., Jr., and Halter, B. L.: Traumatic Pancreatitis With and Without Associated Injuries , Amer J Surg 83:409-412, 1952.Crossref 13. Kinnaird, D. W.: Pancreatic Injuries Due to Non-Penetrating Abdominal Trauma , Amer J Surg 91:552-557, 1956.Crossref 14. Puestow, C. B., and Gillesby, W. J.: Retrograde Surgical Drainage of the Pancreas for Chronic Relapsing Pancreatitis , AMA Arch Surg 76:898-905, 1958.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jun 1, 1963

References