Skip to main content

Factors affecting morbidity and mortality in pancreatic injuries

European Journal of Trauma and Emergency Surgery volume 42, pages 231–235 (2016)Cite this article

Abstract

Purpose

Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma.

Methods

The records of 33 patients who underwent surgery for pancreatic trauma between January 2004 and December 2013 were analyzed retrospectively.

Results

The types of injury were penetrating injury and blunt abdominal trauma in 75.8 and 24.2 % of all cases, respectively. Injuries were classified as stage 1 in 6 cases (18.2 %), stage 2 in 18 cases (54.5 %), stage 3 in 5 cases (15.2 %), and stage 4 in 4 cases (12.1 %). The average injury severity scale (ISS) value was 25.70 ± 9:33. Six patients (18.2 %) had isolated pancreatic injury, 27 (81.2 %) had additional intraabdominal organ injuries and 10 patients (30.3 %) had extraabdominal organ injuries. The mean length of hospital stay was 13.24 ± 9 days. Various complications were observed in eight patients (24.2 %) and mortality occurred in three (9.1 %). Complications were more frequent in patients with high pancreatic damage scores (p = 0.024), additional organ injuries (p = 0.05), and blunt trauma (p = 0.026). Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.

Conclusions

Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Sharpe JP, Magnotti LJ, Weinberg JA, Zarzaur BL, Stickley SM, Scott SE, Fabian TC, Croce MA. Impact of a defined management algorithm on outcome after traumatic pancreatic injury. J Trauma Acute Care Surg. 2012;72:100–5.

    Article  PubMed  Google Scholar 

  2. Akcan A, Akyıldız H, Küçük C, Yılmaz N, Ok E, Sözüer E, Yılmaz Z. Pankreas yaralanmalarında cerrahi tedavi: 15 yıllık deneyim. Ulusal Cerrahi Dergisi. 2006;22:104–8.

    Google Scholar 

  3. Önder A, Gümüş M, Kapan M, Böyük A, Arıkanoğlu Z, Girgin S. Associated organ injuries in pancreatic injuries, morbidity, and mortality. Turk J Med Sci. 2012;42:559–66.

    Google Scholar 

  4. Patton JH, Fabian TC. Complex pancreatic injuries. Surg Clin North Am. 1996;76:782–95.

    Article  Google Scholar 

  5. Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, McAninch JW, Pachter HL, Shackford SR, Trafton PG. Oran injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30:1427–9.

    CAS  Article  PubMed  Google Scholar 

  6. Heitsch RC, Knutson CO, Fulton RL, Jones CE. Delineation of critical factors in the treatment of pancreatic trauma. Surgery. 1976;80:523–9.

    CAS  PubMed  Google Scholar 

  7. Asensio JA, Petrone P, Roldan G, Pak-art R, Salim A. Pancreatic and duodenal injuries. Complex and lethal. Scand J Surg. 2002;91:81–6.

    CAS  PubMed  Google Scholar 

  8. Recinos G, DuBose JJ, Teixeira PG, Inaba K, Demetriades D. Local complications following pancreatic trauma. Injury. 2009;40:516–20.

  9. Vasquez JC, Coimbra R, Hoyt DB, Fortlage D. Management of penetrating pancreatic trauma: an 11-year experience of a level-1 trauma center. Injury. 2001;32:753–9.

    CAS  Article  PubMed  Google Scholar 

  10. Thomas H, Madanur M, Bartlett A, Marangoni G, Heaton N, Rela M. 12-Year experience from a tertiary center. Pancreas. 2009;38:113–6.

    Article  PubMed  Google Scholar 

  11. Miller PR, Croce MA, Bee TK, Malhotra AK, Fabian TC. Associated injuries in blunt solid organ trauma: implications for missed injury in nonoperative management. J Trauma. 2002;53:238–42.

    Article  PubMed  Google Scholar 

  12. Ker-Kan T, Xinhui Chan D, Appasamy V, Ming-Terk C. Management of pancreatic injuries after blunt abdominal trauma. Experience at a single institution. JOP. 2009;10:657–63.

    Google Scholar 

  13. Leppaniemi AK, Haapiainen RK. Risk factors of delayed diagnosis of pancreatic trauma. Eur J Surg. 1999;165:1134–7.

    CAS  Article  PubMed  Google Scholar 

  14. Patton JH Jr, Lyden SP, Croce MA, Martin A, Pritchard FE, Minard G, Kudsk KA, Fabian TC. Pancreatic trauma: a simplified management guideline. J Trauma. 1997;43:234–9.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Zubeyir Bozdag declares that he has no conflict of interest. Murat Kapan declares that he has no conflict of interest. Burak Veli Ulger declares that he has no conflict of interest. Ahmet Turkoglu declares that he has no conflict of interest. Omer Uslukaya declares that he has no conflict of interest. Abdullah Oguz declares that he has no conflict of interest. Mustafa Aldemir declares that he has no conflict of interest.

Compliance with ethical requirements

Because the study was designated retrospectively, an ethical approval was not required.

Author information

Affiliations

  1. Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Z. Bozdag, M. Kapan, B. V. Ulger, A. Turkoglu, O. Uslukaya, A. Oğuz & M. Aldemir

Authors
  1. Z. Bozdag
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Kapan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. V. Ulger
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Turkoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Uslukaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Oğuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Aldemir
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Z. Bozdag.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Bozdag, Z., Kapan, M., Ulger, B.V. et al. Factors affecting morbidity and mortality in pancreatic injuries. Eur J Trauma Emerg Surg 42, 231–235 (2016). https://doi.org/10.1007/s00068-015-0526-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-015-0526-8

Keywords

  • Pancreas
  • Trauma
  • Risk factors
  • Morbidity
  • Mortality