Traumatic pancreatic injuries and treatment outcomes: An observational retrospective study from a high-volume tertiary trauma center

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2024-12-10 DOI:10.1016/j.amjsurg.2024.116142

Lindsey A. Braden , Rebecca Minas-Alexander , Alexis Love , Essam Hashem , Philip Karuman , Amber L. Jones

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Abstract

Introduction

This study discusses a tertiary trauma center's experience involving traumatic pancreatic injuries, focusing on identification, management, and complications, aiming to provide a valuable contribution to the literature on pancreatic trauma management.

Methods

We conducted a five year (2019–2023) retrospective analysis utilizing trauma registry data to identified pancreatic injuries in tier 1 and 2 activations. Pancreatic Organ Injury Scaling (OIS) and overall injury severity (ISS) was assessed using AAST scoring. Data was stratified by mechanism, management, associated injuries, and outcomes.

Results

Thirty-one patients suffering firearm (48.4 %), stabbing (16.1 %), or blunt injuries (35.5 %) were investigated. Firearms correlated with diaphragm (P = 0.047), stomach (P = 0.001) and intrabdominal injury count (P = 0.0042). Robust trends were found between OIS, ISS, complication, mortality and many alike.

Conclusion

In penetrating injury, increasing ISS and number of intrabdominal injuries should heighten pancreatic trauma suspicion and lower the threshold for surgical exploration, particularly when involving the diaphragm, stomach, transverse colon or spleen.

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外伤性胰腺损伤和治疗结果：一项来自大容量三级创伤中心的观察性回顾性研究。

本研究讨论了三级创伤中心涉及外伤性胰腺损伤的经验，重点是识别，管理和并发症，旨在为胰腺创伤管理的文献提供有价值的贡献。方法：我们利用创伤登记数据进行了为期五年（2019-2023）的回顾性分析，以确定1级和2级激活的胰腺损伤。采用AAST评分法评估胰腺器官损伤评分（OIS）和总体损伤严重程度（ISS）。数据按机制、管理、相关损伤和结果进行分层。结果：调查了31例火器伤（48.4%）、刺伤（16.1%）、钝性伤（35.5%）。枪械与膈肌（P = 0.047）、胃（P = 0.001）和腹内损伤计数（P = 0.0042）相关。OIS、ISS、并发症、死亡率等之间存在明显的趋势。结论：在穿透性损伤中，增加ISS和腹腔内损伤的数量应提高胰腺损伤的怀疑，降低手术探查的门槛，特别是当累及膈、胃、横结肠或脾脏时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.