Conservative Management of Traumatic Pancreatitis - Our Experience

Dr. Siddharth Gupta, Dr. Ashish Goyal, Dr. Brijesh Kumar Sharma, Dr. M. C. Misra

Abstract: Introduction: Blunt trauma abdomen leading to pancreatic injury is not only rare, but moreover it's management is still controversial for high grade injuries involving the main pancreatic duct. The aim of the study is to evaluate the outcomes of conservative management of high grade pancreatic injuries. Material & Methods: Review of patients of Blunt Trauma Abdomen with Pancreatic injury at our center between 2018-2020. Cases included had raised Serum Lipase (more than 3 times the normal upper limit), positive ultrasonography and/or Computed Tomography scan having evidence of pancreatic injury. Results: A total of 5 patients fulfilled the inclusion criteria, all male. Isolated pancreatic trauma in 3/5 cases (60%), Grade IV injury in 5/5 cases (100%). Pancreatic complications in 4/5 cases (80%), 2 cases had pseudocyst formation which were managed conservatively initially, and later endoscopically & laparoscopically.2 cases had APFC formation which was managed by percutaneous aspiration.4/5 patients are asymptomatic in follow up. Conclusion: Conservative management can be reserved for patients who are hemodynamically stable and is found to be a safe and effective way to treat High grade pancreatic injuries with good outcomes.

Keywords: Conservative Management, Pseudocyst Pancreas, Acute Peri-Pancreatic Fluid Collection, APFC