Trauma cerrado de abdomen en adultos: lesión pancreática diagnóstico y tratamiento

Abstract

Introduction: Pancreatic lesions are rare due to their anatomical location, which increases their diagnostic difficulty and a higher mortality rate. They occur more frequently in closed traumas, their diagnosis is based mainly on the history, symptoms and pancreatic function with the help of images such as tomography or ERCP to see a duct injury. Treatment primarily consists of resuscitation and stabilization, observation, drainage, distal or total pancreatectomy with splenectomy. Objective: To update the information about blunt abdominal trauma with pancreatic injury to help improve the mortality and morbidity rates of the Hospitals of Ecuador. Materials and Methods: A comprehensive search was carried out on the PubMed, Cochrane, Scielo platform, academic search engines such as Google Scholar, based on scientific articles, clinical practice guidelines, controlled studies, clinical trials and multicenter studies published in indexed journals and applying filters from the last five years. Conclusion: The clinical picture is poor, referring only to epigastric pain radiating to the back and the pancreatic enzymes are not reliable during the first hours. Ultrasound does not rule out pancreatic injury, but tomography is more specific and allows the pancreatic duct to be evaluated. ERCP provides us with a timely diagnosis and is a therapeutic option as a stent collation. Treatment in grades I, II is recommended management observation. Invasive or surgical treatment is indicated in grades III, IV, V and penetrating injuries that complicate the patient's life.