Keywords
Abstract
Purpose: summarize the surgical treatment experience of injuries of the pancreas in closed abdominal trauma.
Materials and methods: We have analyzed the treatment results of 70 patients with injuries to the pancreas treated in the surgical department of the Samarkand branch of the RSCEMA of the Ministry of Health of the Republic of Uzbekistan and its branches from 2009-to 2021. There were 64 (91.4%) men and 6 (8.6%) women aged 18 to 57. Isolated injuries of the pancreas were observed in 20 (29%), multiple - in 32 (45%), and combined - in 18 (26%) patients. In the entire injured, trauma to the pancreas was combined with damage to other organs and systems (liver, spleen, stomach, small and large intestines, retroperitoneal hematoma, brain and spinal cord trauma, chest injury). Damage to the head of the pancreas occurred in 27 (23.5%) patients, body - in 59 (51.3%), tail - in 29 (25.2%) patients.
Results: The clinical picture of trauma to the pancreas was characterized by traumatic shock in 27 patients, internal bleeding - 18 and peritonitis - in 10. An increase in amylase level in blood and urine upon admission was noted in 21 (30.6%) cases; an increase in amylase in 3 more hours was observed in 49 (61.4%) patients. Twelve (17.1%) of 70 patients with dominant damage to the pancreas died. According to our data on the PIMS scale, there were no deaths with mild severity. In the group with moderate severity, four patients died (13.3%), and with severe severity, eight patients died, which amounted to (40%).
Conclusion: The rarity of damage to the pancreas, the peculiarity of the anatomical location of the organ, the absence of pathognomonic signs, and frequent combination with damage to other organs significantly complicates the diagnosis of damage to the pancreas.
In most cases, individual technologies can reveal only indirect signs of damage to internal organs in a closed abdominal trauma, but their use is certainly important because allows to shortens the examination time and clarifies the indications for laparoscopic or open interventions.