CT findings of blunt pancreatic trauma

Objective To find the CT features of pancreatic trauma and its role in the diagnosis. Methods Twenty one consecutive patients, 15 males and 6 females with mean age of 25.6 years ranging from 7 to 50, who underwent abdominal CT following blunt pancreatic trauma and surgically diagnosed as pancreatic injury or clinical pancreatitis between 1997 and 2001 were subjected in this study. Results The pancreatic injury was identified by CT scans in 14 cases. Seven patients who had normal appearing pancreases on CT scan were confirmed to have pancreatic injury with laparotomy or clinical pacreatitis followed up. The type of CT manifestations of pancreatic injury included: (1)pancreatitis,partial in 6 and diffuse in 3 cases;(2)pancreatic transection in 4 cases;(3)pancreatic hematoma in 1. Eight patients not undergoing laparotomy had pancreatitis and/or pancreatic pseudocysts on follow up imaging. Peripancreatic fluid collections on CT were noted in 17 patients. Conclusion CT signs of pancreatic injury include(1)direct signs,such as focal or diffuse pancreas enlargement,contour irregularity,linear area of low attenuation and/or separation,mass with hemorrhage and pesudocyst after trauma in pancreas.(2)indirect signs,such as loss of definition of adjacent fat planes,peripancreatic fluid collections. Pancreatic injury may have a normal appearing pancreas on immediate CT. CT diagnosis of pancreatic injury is difficult when there are associated injury. Follow-up CT is useful in diagnosis of pancreatic injury.