T R A C K       P A P E R
ISSN:2455-3956

World Journal of Research and Review

( A Unit of Nextgen Research Publication)

On Traumatic Lesions of The Pancreas

( Volume 2 Issue 6,June 2016 ) OPEN ACCESS
Author(s):

Giorgio Maria Paolo Graziano, Federica Castelli, Prof Antonino Graziano

Abstract:

Traumatic injuries affecting the pancreas have a statistic or percentage of between 2 and 12% of all injuries in the abdomen (1) in 2/3 of the cases caused by road accidents and a third of cases from wounds, the purpose of this work is to expose the experience gained in a retrospective review of the cases treated pancreatic traumatic pathology asking the guidance and direction to the disease treatment Materials and methods :In the first group were observed 12 patients cu n n n 4 8 blunt trauma and penetrating trauma, injuries associated n 2 cases related to the spleen, liver n 4, n 1 n 1 duodenum transverse colon. In the second group we were n is observed 6 cases of which was present in 4 cases n: n 1 a laceration of the body, n 1 case laceration of the tail, n 2 cases a complete resection of the pancreatic duct observed In cases where were present the traumas blunt: treatment in No 8 cases in which there was a bruise or tear without parenchymal involvement product was done by a simple drainage with a residual n 2 pancreatic fistulas treated with NPT and healed in n n 1 respectively in 30 days , and in 'more in 90 days. In the remaining 10 patients in n n 6 cases in which there was a laceration body and tail with complete detachment of the pancreatic duct associated with the irreparable injury of the spleen we proceeded to a distal pancreatic resection with splenectomy. Results :in the choice of treatment was carried out with a distinction and evaluation of the following criteria: A) evaluation of bruising or tearing, B) the absence or complete or incomplete rupture of the pancreatic duct. c) destruction of the pancreatic head and involvement of the common bile duct. the stage I and II (65-75%). The initial symptoms were absent due to the failure to irritation of the posterior peritoneum, whereby the abutment of the blunt trauma pancreatic at early stage was observe initially following the repairs of the associated lesions. (Colon.milza, bleeding. Instrumental examinations which the CT, MRI, have reduced diagnostic time and rendered obsolete the echo abdomen and video laparoscopy, surveys that collect indirect signs. the lesions of the duct ductal with loss of enzymes resulted in the castings, like cysts and relapsing pancreatitis . lL surgical treatment required further evaluation of parameters such as the site of the lesion, the age that has guided the conservative treatment in young people. Discussion. The instrumental exams (CT and MRI) have reduced the diagnostic and obsoleted times the echo abdomen and video laparoscopy, surveys that collect indirect signs (loss of the contour of the psoas muscle, bleeding retroperitoneal ) of the lesion. It is still useful in cases of perforation of the duodenum associated with the X-ray with gastrografin. . The decision on the type of treatment remains bound to the experience, the technical skills, to 'clinical analysis of the case of the' surge capacity of choice related by the possibilities of success when the traumatic event is evolving. The success of the surgical treatment had need of complementary therapy. The NPT with the suspension of food transit, pharmacological reduction of pancreatic secretion, the contribution of parenteral nutrition with a low-fat diet has provided advantages in terms of reduction of complications. during surgery mortality ranges from a statistical check by 12.3% to 29.6% depending on whether it's a simple drainage or DPC. In the cases it considered the values were slightly higher from 16.2% to 32.5% Conclusions The incidence of pancreatic trauma is steadily increasing due to the presence of a massive motorization that involves an increase in the number of road accidents. the use of digitized diagnostic (CT and MRI) has reduced the time and diagnostic delays especially in blunt trauma, with the identification of the major pancreatic duct lesions. It remains to define the problem of identification of minute lesions due to pancreatic fistulas. The success of surgical treatment remains anchored to trauma treatment in the developmental phase, associated with the experience and technical and analytical ability to choose what and when to implement the most appropriate therapeutic treatment.

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