Pancreatic injury due to blunt trauma on CT: does retropancreatic fat tissue reduce the severity of pancreatic injury?

BACKGROUND Pancreatic injuries from blunt abdominal trauma have a high mortality rate, often accompanied by injuries to adjacent organs. This study aims to investigate the relationship between the size of retropancreatic adipose tissue and the severity of pancreatic and adjacent organ injuries in patients with pancreatic trauma. METHODS We retrospectively screened computed tomography (CT) images of 34 patients (25 males, nine females, aged 13-69 years) and 34 controls (28 males, six females, aged 15-66 years) who suffered blunt abdominal trauma. The area of adipose tissue located posterior to the pancreatic body was measured in the axial plane for all subjects. The severity of pancreatic injury was assessed in terms of the injury site, the retropancreatic adipose tissue area, and the degree of other organ injuries. RESULTS Pancreatic injuries were located in the head for 16 patients (23.5%), in the body for four patients (5.9%), and in the tail for 14 patients (20.6%). The retropancreatic fat area was found to be significantly smaller in patients with pancreatic trauma compared to controls (p<0.0001). Furthermore, the ratio of the retropancreatic fat area to the vertebral corpus area differed significantly between patients with and without pancreatic injuries (p=0.014). CONCLUSION Retropancreatic adipose tissue protects the pancreatic body from the impacts of blunt abdominal trauma. An increased amount of retropancreatic adipose tissue is associated with a reduced rate of pancreatic injury.