Pancreatic trauma: The role of computed tomography for guiding therapeutic approach

• 作者: Amato A Stabile Ianora Antonio Margari Dario Dabbicco Giuseppe Angelelli Laura Mappa Marco Moschetta Michele Telegrafo Valeria Malagnino
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: TRAUMA PANCREAS COMPUTED TOMOGRAPHY Imaging
• 年，卷（期）: 2015,（11）
• 页码范围: 415-420
• 页数: 6页
• 分类号: R576

摘要

AIM: To evaluate the role of computed tomography(CT) for diagnosing traumatic injuries of the pancreas and guiding the therapeutic approach.METHODS: CT exams of 6740 patients admitted to our Emergency Department between May 2005 and January 2013 for abdominal trauma were retrospectively evaluated. Patients were identified through a search of our electronic archive system by using such terms as "pancreatic injury", "pancreatic contusion", "pancreatic laceration", "peri-pancreatic fluid", "pancreatic active bleeding". All CT examinations were performed before and after the intravenous injection of contrast material using a 16-slice multidetector row computed tomography scanner. The data sets were retrospectively analyzed by two radiologists in consensus searching for specific signs of pancreatic injury(parenchymal fracture and laceration, focal or diffuse pancreatic enlargement/edema, pancreatic hematoma, active bleeding, fluid between splenic vein and pancreas) and non-specific signs(inflammatory changes in peri-pancreatic fat and mesentery, fluid surrounding the superior mesentericartery, thickening of the left anterior renal fascia, pancreatic ductal dilatation, acute pseudocyst formation/peri-pancreatic fluid collection, fluid in the anterior and posterior pararenal spaces, fluid in transverse mesocolon and lesser sac, hemorrhage into peri-pancreatic fat, mesocolon and mesentery, extraperitoneal fluid, intraperitoneal fluid).RESULTS: One hundred and thirty-six/Six thousand seven hundred and forty(2%) patients showed CT signs of pancreatic trauma. Eight/one hundred and thirty-six(6%) patients underwent surgical treatment and the pancreatic injures were confirmed in all cases. Only in 6/8 patients treated with surgical approach, pancreatic duct damage was suggested in the radiological reports and surgically confirmed in all cases. In 128/136(94%) patients who underwent non-operative treatment CT images showed pancreatic edema in 97 patients, hematoma in 31 patients, fluid between splenic vein and pancreas in 113