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pancreatic trauma

Laura Montoya-Sánchez, Rocío Del P Pereira-Ospina, Javier Y Pinzón-Salamanca, José M Suescún-Vargas
Pancreatitis consists in acute inflammation of the pancreas that is clinically characterized by abdominal pain. To make the diagnosis it is necessary the elevation of biochemical markers like pancreatic amylase or lipase. It is the most frequent pancreatic disease in both children and adults. Its presentation in the pediatric population is increasing and has several etiologies such as: infections, trauma, intoxication and metabolic diseases. Trauma mechanisms have been described: child maltreatment, falls, trauma with the bicycle handle and traffic accidents...
April 1, 2018: Archivos Argentinos de Pediatría
Vishal Sharma, Sarthak Malik, Harshal S Mandavdhare, Harjeet Singh
Endoscopic retrograde cholangio-pancreatography (ERCP) is an important tool for treatment of pancreaticobiliary diseases. However, ERCP may be difficult in patients who have altered gastrointestinal anatomy due to congenital or surgical reasons. A 40-year-old male with HIV infection presented with abdominal pain following abdominal trauma. The patient was diagnosed to have traumatic pancreatic injury and underlying situs inversus. The pancreatic fluid collection was drained using radiology guided pigtail placement done for the symptoms of abdominal pain and vomiting...
February 2018: Intractable & Rare Diseases Research
Jack Braha, Scott Tenner
Pseudocysts evolve from fluid collections and/or disruptions of the pancreatic duct. They may occur secondary to acute pancreatitis, pancreatic trauma, or chronic pancreatitis. Lacking the clinical information, radiologists may inappropriately call a fluid collection or any cystic lesion a pseudocyst. With no clear history of acute pancreatitis or chronic pancreatitis, this is rare. Complications include infection, intracystic hemorrhage, or rupture. Pseudocysts can become painful, especially with chronic pancreatitis, and can cause early satiety and weight loss when their size affects the stomach and bowel...
April 2018: Gastrointestinal Endoscopy Clinics of North America
Sergio Henrique Bastos Damous, George Felipe Bezerra Darce, Renato Silveira Leal, Adilson Rodrigues Costa, Pedro Henrique Alves Ferreira, Celso de Oliveira Bernini, Edivaldo Massazo Utiyama
INTRODUCTION: Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. PRESENTATION OF CASE: Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head...
February 15, 2018: International Journal of Surgery Case Reports
Bogdan Augustin Chis, Daniela Fodor
Glucagon-like peptide 1 receptor agonists (GLP-1RA) are the newest treatment for diabetes mellitus (DM). These drugs can down-regulate fasting glucose more than oral drugs and lead to more constant glucose levels compared to regular insulin. Acute pancreatitis is a serious condition that may have a fatal outcome. It has been shown that long term and high doses of GLP-1RA can cause pancreatic changes in animals, but no connection has been proven in humans. We present the case of a 67 years old man with DM treated with oral drugs for 10 years until 3 months before, when GLP-1RA was added...
2018: Clujul Medical (1957)
Hussein A Khambalia, M Yvonne Alexander, Mahesan Nirmalan, Ria Weston, Phillip Pemberton, Zia Moinuddin, Angela Summers, David van Dellen, Titus Augustine
In sepsis, trauma and major surgery, where an explicit physiological insult leads to a significant systemic inflammatory response, the acute evolution of biomarkers have been delineated. In these settings, Interleukin (IL) -6 and TNF-α are often the first pro-inflammatory markers to rise, stimulating production of acute phase proteins followed by peaks in anti-inflammatory markers. Patients undergoing SPKT as a result of diabetic complications already have an inflammatory phenotype as a result of uraemia and glycaemia...
February 8, 2018: Cytokine
Cheng-Shyuan Rau, Shao-Chun Wu, Peng-Chen Chien, Pao-Jen Kuo, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh, Hang-Tsung Liu
BACKGROUND: In trauma patients, pancreatic injury is rare; however, if undiagnosed, it is associated with high morbidity and mortality rates. Few predictive models are available for the identification of pancreatic injury in trauma patients with elevated serum pancreatic enzymes. In this study, we aimed to construct a model for predicting pancreatic injury using a decision tree (DT) algorithm, along with data obtained from a population-based trauma registry in a Level I trauma center...
February 6, 2018: International Journal of Environmental Research and Public Health
Rosalie Yandell, Marianne Chapman, Stephanie O'Connor, Alison Shanks, Kylie Lange, Adam Deane
AIM: To determine whether the placement of a post-pyloric feeding tube (PPFT) can be taught safely and effectively to a critical care dietitian. METHODS: This is a prospective observational study conducted in an adult intensive care unit (ICU). The intervention consisted of 19 attempts at post-pyloric intubation by the dietitian. The 10 'learning' attempts were performed by the dietitian under the direction of an experienced (having completed in excess of 50 successful tube placements) user...
February 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
Muhammad Yasir, Muhammad Qamarul Hoda, Tauseef Ahmed
Abdominal compartment syndrome (ACS) is increasingly identified in critically ill patient and its harmful effects are well documented. The disparity among the pressure, volume in abdominal cavity and its contents, results in ACS. The actual incidence of ACS is not known. However, it has been observed predominantly in patients with severe blunt and penetrating abdominal trauma, ruptured abdominal aortic aneurysms, retro- and intra-peritoneal hemorrhage, pneumoperitoneum, neoplasm, pancreatitis, ascites and multiple bone fracture...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Emmanuel Ofori, Tagore Sunkara, Eric Then, Febin John, Vinaya Gaduputi
Intramural duodenal hematoma (IDH) is a rare complication in endoscopic management of ulcer hemorrhage. Usually noted in cases of blunt abdominal trauma, non-traumatic IDHs have been reported in individuals on anticoagulation, with blood disorders, pancreatic diseases and in endoscopic procedures such as biopsy, sclerotherapy and argon plasma coagulation. Patients may be asymptomatic or present with acute blood loss anemia, abdominal pain or vomiting. We report a case of an 83-year-old man with melena and syncope who underwent endoscopy for bleeding ulcer control and subsequently developed acute pancreatitis due to an acute IDH...
January 2018: Oxford Medical Case Reports
Ravi Kumar Garg, Jai Kumar Mahajan
Purpose: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. Methods: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. Results: Age of the patients ranged from 3-11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
Stefania Cimbanassi, Osvaldo Chiara, Ari Leppaniemi, Sharon Henry, Thomas M Scalea, Kathirkamanathan Shanmuganathan, Walter Biffl, Fausto Catena, Luca Ansaloni, Gregorio Tugnoli, Elvio De Blasio, Arturo Chieregato, Giovanni Gordini, Sergio Ribaldi, Maurizio Castriconi, Patrizio Festa, Federico Coccolini, Salomone di Saverio, Antonio Galfano, Massimo Massi, Marilena Celano, Massimiliano Mutignani, Stefano Rausei, Desiree Pantalone, Antonio Rampoldi, Luca Fattori, Stefano Miniello, Sebastian Sgardello, Francesca Bindi, Federica Renzi, Fabrizio Sammartano
No abstract text is available yet for this article.
March 2018: Journal of Trauma and Acute Care Surgery
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
Jonathan G Martin, Jay Shah, Craig Robinson, Sean Dariushnia
Trauma is a leading cause of death in patients under the age of 45 and generally associated with a high kinetic energy event such as a motor vehicle accident or fall from extreme elevations. Blunt trauma can affect every organ system and major vascular structure with potentially devastating effect. When we consider abdominal solid organ injury from blunt trauma, we usually think of the liver, spleen, and kidneys. However, all of the abdominal organs, including the pancreas and adrenal glands, may be involved...
December 2017: Techniques in Vascular and Interventional Radiology
Nnamdi Arinze Nwafo
Acute pancreatitis is a well-recognised complication of endoscopic procedures like endoscopic retrograde cholangiopancreatography but not oesophagogastroduodenoscopy (OGD). I report a case of a 33-year-old woman, admitted with severe epigastric pain and vomiting 2 hours after an elective OGD for evaluation of chronic gastrointestinal symptoms. Pancreatitis was diagnosed on the basis of elevated lipase (40 790 U/L; normal 11-82) and findings on imaging studies. Other common causes of acute pancreatitis such as gallstones, alcohol and medications were ruled out...
December 7, 2017: BMJ Case Reports
Amit Gupta, Subodh Kumar, Sanjay Kumar Yadav, Biplab Mishra, Maneesh Singhal, Atin Kumar, Pramod Garg
Pancreatic injury is an uncommon and frequently missed injury in abdominal trauma patients. However, missed pancreatic injury is associated with significant morbidity and mortality. This study was conducted to know the burden of pancreatic injury and its outcome in our setup. A retrospective analysis of 53 patients with pancreatic injury from January 2008 through March 2012 at the Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi. Pancreatic injuries were present in 1...
December 2017: Indian Journal of Surgery
Myftar Torba, Arben Gjata, Francesco Rulli, Ilir Kajo, Sotir Ceka, Tajar Asqeri
INTRODUCTION: Despite technological advancement, high grade pancreatic injuries following blunt abdominal trauma continues to remain a disease that is associated with high morbidity and mortality rates, particularly in cases of delayed diagnosis. The aim of this paper was the presentation of delayed diagnosis and treatment peculiarities of high grade pancreatic trauma and a review of literature. CASE REPORT: A 55-years old man, involved in motor vehicle crashes, was referred to our level I trauma center...
November 29, 2017: Annali Italiani di Chirurgia
Shahin Mohseni, Jeremy Holzmacher, Gabriel Sjolin, Rebecka Ahl, Babak Sarani
BACKGROUND: High-grade traumatic pancreatic injuries are associated with significant morbidity and mortality. Non-resection management is associated with fewer complications in pediatric patients. The present study evaluates outcomes following resection versus non-resection management of severe pancreatic injury caused by penetrating trauma. METHODS: A retrospective study of the Trauma Quality Improvement Program (TQIP) database was performed from 1/2010 to 12/2014...
January 2018: Injury
Eric H Rosenfeld, Adam M Vogel, Denise B Klinkner, Mauricio Escobar, Barbara Gaines, Robert Russell, Brendan Campbell, Hale Wills, Anthony Stallion, David Juang, Rajan K Thakkar, Jeffrey Upperman, Mubeen Jafri, Randall Burd, Bindi J Naik-Mathuria
BACKGROUND/PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) is an adjunct for pediatric pancreatic injury management, but its use and utility in pediatric patients are unclear. We set out to evaluate the use of ERCP and its effects on outcomes. METHODS: A retrospective review was performed for children who had pancreatic injuries at 22 pediatric trauma centers between 2010 and 2015. ERCP details and outcomes were collected. Analysis was performed using descriptive statistics and Wilcoxon rank-sum tests...
October 13, 2017: Journal of Pediatric Surgery
Majid Hajimaghsoudi, Faezeh Zeinali, Mehrdad Mansouri, Mohammad Hosein Dehghani
BACKGROUND: Acute pancreatitis has different etiologies from biliary stone to metabolic disturbances. Coronary angiography is one of the newly understood etiologies. CASE REPORT: This paper is about a women suffering from acute pancreatitis after coronary angiography. CONCLUSION: Embolization of cholesterol crystals due to vessel wall trauma during coronary angiography as well as contrast medium are responsible for such side effect.
May 2017: ARYA Atherosclerosis
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