June 1963

The Surgical Significance of Trauma to the Pancreas

Author Affiliations

From the Department of Surgery and the Hektoen Institute for Medical Research of the Cook County Hospital and the Department of Surgery of the University of Illinois College of Medicine.

Arch Surg. 1963;86(6):1038-1044. doi:10.1001/archsurg.1963.01310120156022

Introduction  Pancreatic trauma has long been a neglected realm in abdominal injury, largely because the pancreas has been considered to be a friable, relatively inaccessible, and highly hazardous structure with which to work. Nevertheless, as trauma assumes an increasingly important role in surgery, some valuable therapeutic principles have emerged.Few reports of substantial series of nonoperative pancreatic injury have appeared until recently. With high-speed travel and the resultant injuries continually increasing, greater emphasis is being placed on salvage of patients with severe and, frequently, multiple injuries.The pancreas occupies an unfortunate position, for the patient and the surgeon, being centrally placed and overlying the relatively rigid aorta and vertebral column. A force striking the abdomen anteriorly may directly tear or fracture the gland, or a contrecoup injury may result. Injury is more likely to occur if the force strikes the relaxed abdomen, or if the patient is unconscious.Penetrating wounds

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