66.17 Pancreatic injuries

These injuries range from mild bruising to a pancreas which has been cut vertically in half. The patient may have few physical signs until a spreading retroperitoneal abscess develops.

If his pancreas is only bruised, you can drain it. This can be life–saving. A pancreatic fistula will probably form, but it can be treated after he has recovered from his acute injury. Pancreatectomy is the treatment of choice for major injuries. This is difficult, so close his abdomen and if possible refer him rapidly. The only exception is an injury to the tip of the tail of the pancreas.