Blunt trauma to pancreas

• Blunt trauma to pancreas is usually caused by compression against the vertebral column; the best and most common example is seat belt compression injuries. Blunt trauma to pancreas is Usually associated with upper abdominal visceral injury.
• Graded from minor contusion and capsular haematoma (grade I) to severe devascularising crush injury (grade IV).
• Pancreatic trauma is usually damage occurs at most vulnerable segment of pancreas: the junction of the body and tail.

Radiological features

- CECT:
•Laceration–area of intrapancreatic low attenuation, often difficult to see.
•Direct evidence of haemorrhage – fluid around superior mesenteric artery and pancreas.
•Indirect evidence – thickening of anterior pararenal fascia.
- Often requires delayed scans to exclude/monitor complications of pancreatitis and devascularised pancreas.

Complications of Blunt trauma to pancreas

• Post-traumatic pancreatitis, with:

1.  peripancreatic fat stranding
2.  diffuse or focal pancreatic enlargement
3.  irregular pancreatic contour.

• Splenic vessel fistula or arterial pseudoaneurysm.
• Pancreatic abscess.
• Pancreatic pseudocyst.

Pancreatic trauma. Laceration of the pancreas within the proximal body (arrow heads).