CHRONIC OBSTRUCTIVE PANCREATITIS AS A DELAYED COMPLICATION OF PANCREATIC TRAUMA

Increasing surgical experience with the immediate consequences of pancreatic injuries has resulted from parallel growth in the volume of motor vehicle accidents and societal violence. However, few surgeons are aware that complications may be considerably delayed following pancreatic trauma, occurrin...

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Bibliographic Details
Published in:HPB Surgery 1991, Vol.1991 (1), p.b49-60
Main Author: Bradley, 3rd, E L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Chronic Disease
Constriction, Pathologic - etiology
Female
Humans
Male
Pancreas - injuries
Pancreatic Diseases - etiology
Pancreatic Ducts
Pancreatitis - etiology
Time Factors
Wounds, Nonpenetrating - complications
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Summary:Increasing surgical experience with the immediate consequences of pancreatic injuries has resulted from parallel growth in the volume of motor vehicle accidents and societal violence. However, few surgeons are aware that complications may be considerably delayed following pancreatic trauma, occurring in some cases months to years after apparent recovery from the original injury. In four patients with blunt pancreatic trauma initially treated by non-operative means, stricture of the main pancreatic duct developed over a period of months as a result of progressive fibrosis at the site of ductal injury. Pancreatic duct hypertension was demonstrated to be present in the obstructed duct, and secondary changes of chronic pancreatitis developed in the obstructed segment of the gland (＂upstream＂ chronic pancreatitis). Seven similar patients with delayed onset of chronic obstructive pancreatitis after pancreatic trauma were found in the literature. Symptoms related to these acquired ductal strictures are most commonly those of abdominal pain and recurrent episodes of acute pancreatitis. Recognition of post-traumatic chronic obstructive pancreatitis principally involves awareness that injuries to the pancreatic duct can produce remote complications. Pancreatoenteric drainage, or resection of the obstructed segment of pancreas, provides prompt and effective relief.
ISSN:0894-8569
1607-8462
DOI:10.1155/1991/73834