Imaging abdomen trauma pancreatic trauma part 4 dr ahmed esawy blunt abdominal trauma penetrating abdominal trauma fast abdominal ultrasound haemoperitoneum pneumoperitoneum american association of surgeon in trauma AAST SUBCAPSULAR HAEMATOMA PARENCHYMAL LACERATION PANCREATIC LACERATION PANCREATIC CONTUSION PANCREATIC HAEMATOMA

2. PANCREATIC INJURY
It is relatively uncommon being encountered in
around 3 % of abdominal trauma, usually caused by
blunt trauma.
FAST has a limit role in acute pancreatic injury.
CT is the most reliable imaging modality.
MRCP is useful in evaluating PD disruption and
associated fluid collection.

3. CT Findings In Pancreatic Injury
Thickened anterior pancreatic fascia and fluid in the
lesser sac.
Fluid rim between pancreas and splenic vein.
Focal pancreatic contusion and hematoma.

4. Pancreatic Laceration

5. PANCREATIC TRAUMA

6. PANCREATIC TRAUMA

7. A CT scan performed after abdominal trauma showing diffuse pancreatic
enlargement and was interpreted as suspicious for pancreatic injury. (Grade 1
injury).

8. Follow-up CT scan 3 days after abdominal trauma
revealing a tear of the pancreatic body.

9. A CT scan performed 7 months after surgery showing the
presence of a pseudocyst adjacent to the point of injury

10. Laceration of the
pancreatic neck without
duct injury

11. Pancreatic transection (neck)
with duct injury

12. Subtle pancreatic contusion

13. Indirect Signs
• Edema with global pancreatic enlargement and
loss of lobulation
• Peripancreatic fat infiltration
• Peripancreatic fluid, especially if it is located
around the SMA or the omental bursa
• Hematic fluid between the dorsal surface of the
pancreas and the splenic vein
• Thickening of the left anterior pararenal fascia or
fluid in the anterior pararenal space
• Concomitant duodenal injury

14. Serum amylase, hematocrit and hemoglobin values during
the initial three days after abdominal trauma.

15. THANK YOU