Following a motor vehicle accident, a truck driver complains of severe abdominal pain. Serum amylase level is markedly increased to 800 U. Grey Turner's sign is seen in the flanks. Pancreatic trauma is suspected. Which statement is true of pancreatic trauma?
High-Yield Explanation
Because of its protected retroperitoneal location, pancreatic injury occurs with deep penetrating wounds or with significant blunt trauma to upper abdomen. Blunt trauma accounts for less than 20-30% of all pancreatic injuries. The most common site of injury is at the neck of the pancreas where the pancreatic tissue is compressed against the spine. Associated visceral and vascular injuries occur commonly and together with the delay in diagnosis account for the high morbidity and mortality. Fistulae, pseudocyst, infection, and secondary (delayed) hemorrhage are common complications. Pancreatic injuries frequently are overlooked initially, and their detection requires a high index of suspicion. Elevation of amylase after trauma is nonspecific.