THE incidence of major solid visceral injury and, especially, severe pancreatic injury has been increasing steadily over the past 15 years in keeping with the increase in high-speed automotive trauma. The treatment of wounds of the pancreas, however, has resulted in fewer complications as surgeons have adopted a more aggressive approach toward crushing pancreatic injuries.
Pancreatic fistula is an uncommon complication of trauma, appearing postoperatively in 4% to 6% of patients. Most studies of fistulae have dealt with postoperative leakage of pancreatic juice following drainage or marsupialization of inflammatory pseudocysts, or those which presented as a complication of elective pancreatic or gastroduodenal surgery. The irregular anatomy of the pancreatic ductal system and the fragile nature of the organ combine to make ductal damage or disruption a real hazard in dissection in the vicinity of the head of the gland.
During the past year, 11 patients were admitted to the Trauma
Baker RJ, Bass RT, Zajtchuk R, Strohl EL. External Pancreatic Fistula Following Abdominal Injury. Arch Surg. 1967;95(4):556-566. doi:10.1001/archsurg.1967.01330160026004