Clinical value of CT examination in early pancreatic trauma

Objective:To evaluate the clinical value of CT examination in early diagnosis of pancreatic trauma.Methods:The CT data of seventeen patients with pancreatic trauma were retrospectively reviewed and according to the operative findings,the initial CT findings and 24 hour dynamic characteristics were analysed.Results:All patients were identified by exploratory laparotomy with pancreatic contusions in 11 cases and pancreatic lacerations in 6 cases.The initial abdominal CT was positive for pancreatic trauma in 12 patients(sensitivity 70%) showed the pancreas was normal-appearing in 3 patients,and missed the presence of pancreatic trauma in the other 2 patients.In addition,24 hour CT dynamic follow-up was performed in 10 of all 17 patients and as a result,more clear and convincing CT evidences of pancreatic trauma were found in each case.Conclusion:As pancreatic trauma are usually associated with other abdominal injuries and lack specific clinical findings,they are apt to be missed in early clinical diagnosis.Pancreatic trauma include parenchymal injuries and ductal ruptures.Most of pancreatic parenchymal injuries can be demonstrated on early CT scan. CT fails to provide direct signs of ductal ruptures.It is necessary for patients in steady-state hemodynamics to undergo close follow-up CT in early diagnosis of pancreatic trauma and choosing the optimal therapeutic approach.