PANCREATIC INJURIES FOLLOWING ABDOMINAL TRAUMA: DEMOGRAPHICS, IMAGING PATTERNS, AND MANAGEMENT OUTCOMES

Abstract

Introduction: Pancreatic trauma, though uncommon, carries significant morbidity due to its retroperitoneal location and proximity to vital structures. Blunt trauma, particularly road traffic accidents, is the leading cause, with clinical features often nonspecific. Early radiological evaluation is crucial for detecting parenchymal and ductal injuries and guiding management. Method: A prospective case series was conducted at a tertiary trauma center, including 37 patients with confirmed pancreatic injury. Demographics, mechanism of injury, clinical presentation, radiological findings, and management strategies were recorded. Parenchymal injuries were categorized as contusion, laceration, transection, or gangrene, and ductal involvement as present, suspected, or absent. Management was either conservative or surgical based on injury severity and hemodynamic stability. ICU requirement and postoperative outcomes were assessed. Statistical analysis was performed using chi-square/Fisher’s exact tests, with p <0.05 considered significant. Results: The mean age was 29.9 ± 12.0 years, with male predominance (86.5%). Road traffic accidents were the most frequent mechanism (48.6%). Abdominal pain (100%) and vomiting (89.2%) were common. Parenchymal injury occurred in 89.2%, mainly lacerations (37.8%) and transections (29.7%), while ductal injury was present in 41.7%. ICU admission was significantly associated with ductal injury (p = 0.037). Among 13 surgically treated patients, early complications (61.5%) were more common than late complications. Conclusion: Ductal involvement predicts higher ICU need and postoperative complications. Early radiological diagnosis and risk stratification are essential for optimizing outcomes in pancreatic trauma.