Surgical management of blunt pancreatic trauma: a modus operandi or individualized therapy?

The overall rate of blunt pancreatic trauma observed in level one trauma centers is rather low compared to other injuries, with a reported prevalence of 0.4 per 100,000 hospital admissions. The situation may be further complicated by the presence of associated major visceral injuries in these patients. A number of previous reports indicate that blunt pancreatic trauma carries high morbidity and mortality rates, especially when diagnosis is delayed or inappropriate surgery is attempted. Many mandate prompt surgical explorations for organ-specific diagnosis on CT; however other literature and upcoming studies prove otherwise. Over the years, several technologic advances have increased the sophistication of non-operative management. In our case, a period of careful observation followed by surgical intervention did not adversely effect the outcome. The period of observation resulted in stabilization of other solid organ injuries with focus on pancreas during surgical exploration.