Published: 2019-04-29

Management of isolated high grade blunt pancreatic injury; case report on lesser aggressive approach

Manjit Singh, Mritunjay Sarawagi, Anjay Kumar, Uday Kumar


Isolated high grade pancreatic injury is rare after blunt abdominal trauma. It is a rare entity to appreciate intra-operatively and a high index of suspicion should always be kept in mind to reach the diagnosis. We are presenting our experience of four cases with moderate to high grade isolated pancreatic injury which were managed in a lesser aggressive approach and had an uneventful outcome.


Distal transection, Grade III pancreatic injury, Pancreatic trauma

Full Text:



Tavers B. Rupture of the pancreas, Lancet. 1827;12:384.

Shilyansky J, Sena LM, Kreller M, Chait P, Babyn PS, Filler RM, et al. Nonoperative management of pancreatic injuries in children. J Pediatr Surg. 1998;33:343-9.

Moore EE. Organ injury scaling. II. Pancreas, duodenum, small bowel, colon, and rectum, J Trauma. 1990;30:1427-9.

Hirshberg A, Mattox KL. Top knife: the art and craft of trauma surgery, New York, 2006, Springer-Verlag, p 127.

Hoey BA, Schwab CW. Damage control surgery, Scand J Surg. 2002;91:92-103.

Phelan HA, Velmahos GC, Jurkovich GJ, Friese RS, Minei JP, Menaker JA, et al. An evaluation of multidetector computed tomography in detecting pancreatic injury: results of a multicenter AAST study. J Trauma. 2009;66:641-7.

Bansal V. The utility of seatbelt signs to predict intra-abdominal injury following motor vehicle crashes, Traffic Ing Prev. 2009;10:567-72.

Wright MJ, Stanski C. Blunt pancreatic trauma: a difficult injury, South Med J. 2000;93:383-5.

Adamson WT. Serum amylase and lipase alone are not cost effective screening methods for pediatric pancreatic trauma, J Pediatr Surg. 2003;38:354-7.

Biffl WL. Duodenum and pancreas. In: Mattox KL, Moore EE, Feliciano DV, eds. Trauma. 7th ed. New York, NY: McGraw-Hill. 2012:603-19.

Reddy DA, Reddy VV, Sivaramakrishna G, Chandramaliteeswaran C, Rao MB. Pancreatic trauma: a less aggressive approach is safe. HPB. 2016;18:e451.