Imaging of blunt pancreatic trauma : the value of initial and sequential CT examinations

2008
journal article
article
dc.abstract.enBackground: The purpose of the study was to assess the value of initial, repeated and sequential computed tomography (CT) in patients with blunt pancreatic trauma, and then define and correlate CT findings with endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), ultrasound (US), both laboratory and surgical findings. Material/Methods: This retrospective study covers an eight-year period from 1999 to 2007. The material includes 21 patients (17 males and 4 females) with confirmed pancreatic injury. CT was performed on admission in all cases and in 15 cases follow-up CT was performed from 24 hrs to 14 days later. US was performed in 9 cases, ERCP in 8 cases and MRCP in one case. Serum amylase level was obtained at the admission in all cases. Results: The CT at admission was positive in 17 patients (81.0%); the diagnosis was missed in 4 patients (19.0%), all performed on single row spiral CT. In all these four cases repeated CT was positive. ERCP showed rupture of the main pancreatic duct in 7 cases, one was inconclusive. One MRCP was positive. The serum amylase was elevated in 14 cases (66.7%) Specific CT features in initial and repeated examinations together were: organ fracture - 33.3%, swelling - 38.1%, haematoma/contusion - 38.1%, fluid between splenic vein and pancreas - 19.0%. Non-specific features were: thickening of anterior-renal fascia - 23.8%, fluid in lesser sac - 28.6%, extra peritoneal fluid - 42.9%, associated splenic injury - 14.3% and intraperitoneal fluid - 38.1%. On retrospective analysis, two out of four false negative CT results could have been avoided. No correlation between the CT features and the outcome of surgical and conservative management could be found in this study. Conclusions: A proper technique and accurate reading of images are mandatory for the diagnosis of pancreatic injury. When CT performed on admission is negative and there is abdominal pain and an elevated serum amylase, CT examination should be repeated within 24-48 hours.pl
dc.contributor.authorSzmigielski, Wojciechpl
dc.contributor.authorDarweesh, Adhampl
dc.contributor.authorKassem, Hassanpl
dc.contributor.authorAlhilli, Shathapl
dc.contributor.authorIsmail, Mustafapl
dc.contributor.authorAllam, Hishampl
dc.date.accession2019-05-17pl
dc.date.accessioned2019-05-17T09:30:08Z
dc.date.available2019-05-17T09:30:08Z
dc.date.issued2008pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.additionalBibliogr. s. 44-45pl
dc.description.number3pl
dc.description.physical37-45pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume73pl
dc.identifier.articleid866877pl
dc.identifier.eissn1899-0967pl
dc.identifier.issn1733-134Xpl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/75035
dc.identifier.weblinkhttp://archiwum.inforadiologia.pl/download/index/idArt/866877.htmlpl
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enpancreaspl
dc.subject.eninjurypl
dc.subject.enCTpl
dc.subject.enERCPpl
dc.subject.enMRCPpl
dc.subject.enultrasoundpl
dc.subtypeArticlepl
dc.titleImaging of blunt pancreatic trauma : the value of initial and sequential CT examinationspl
dc.title.journalPolish Journal of Radiologypl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Background: The purpose of the study was to assess the value of initial, repeated and sequential computed tomography (CT) in patients with blunt pancreatic trauma, and then define and correlate CT findings with endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP), ultrasound (US), both laboratory and surgical findings. Material/Methods: This retrospective study covers an eight-year period from 1999 to 2007. The material includes 21 patients (17 males and 4 females) with confirmed pancreatic injury. CT was performed on admission in all cases and in 15 cases follow-up CT was performed from 24 hrs to 14 days later. US was performed in 9 cases, ERCP in 8 cases and MRCP in one case. Serum amylase level was obtained at the admission in all cases. Results: The CT at admission was positive in 17 patients (81.0%); the diagnosis was missed in 4 patients (19.0%), all performed on single row spiral CT. In all these four cases repeated CT was positive. ERCP showed rupture of the main pancreatic duct in 7 cases, one was inconclusive. One MRCP was positive. The serum amylase was elevated in 14 cases (66.7%) Specific CT features in initial and repeated examinations together were: organ fracture - 33.3%, swelling - 38.1%, haematoma/contusion - 38.1%, fluid between splenic vein and pancreas - 19.0%. Non-specific features were: thickening of anterior-renal fascia - 23.8%, fluid in lesser sac - 28.6%, extra peritoneal fluid - 42.9%, associated splenic injury - 14.3% and intraperitoneal fluid - 38.1%. On retrospective analysis, two out of four false negative CT results could have been avoided. No correlation between the CT features and the outcome of surgical and conservative management could be found in this study. Conclusions: A proper technique and accurate reading of images are mandatory for the diagnosis of pancreatic injury. When CT performed on admission is negative and there is abdominal pain and an elevated serum amylase, CT examination should be repeated within 24-48 hours.
dc.contributor.authorpl
Szmigielski, Wojciech
dc.contributor.authorpl
Darweesh, Adham
dc.contributor.authorpl
Kassem, Hassan
dc.contributor.authorpl
Alhilli, Shatha
dc.contributor.authorpl
Ismail, Mustafa
dc.contributor.authorpl
Allam, Hisham
dc.date.accessionpl
2019-05-17
dc.date.accessioned
2019-05-17T09:30:08Z
dc.date.available
2019-05-17T09:30:08Z
dc.date.issuedpl
2008
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.additionalpl
Bibliogr. s. 44-45
dc.description.numberpl
3
dc.description.physicalpl
37-45
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
73
dc.identifier.articleidpl
866877
dc.identifier.eissnpl
1899-0967
dc.identifier.issnpl
1733-134X
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/75035
dc.identifier.weblinkpl
http://archiwum.inforadiologia.pl/download/index/idArt/866877.html
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
pancreas
dc.subject.enpl
injury
dc.subject.enpl
CT
dc.subject.enpl
ERCP
dc.subject.enpl
MRCP
dc.subject.enpl
ultrasound
dc.subtypepl
Article
dc.titlepl
Imaging of blunt pancreatic trauma : the value of initial and sequential CT examinations
dc.title.journalpl
Polish Journal of Radiology
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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