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Date Published: 27/04/2023
Abstract Views: 429
Views PDF: 119
DOI: https://doi.org/10.51298/vmj.v525i2.5171
Issue
Vol. 525 No. 2 (2023)
Section
Các bài báo
How to Cite
Thái , N. H. . (2023). EVALUATION THE RESULT OF DIAGNOSIS AND TREATMENT OF BLUNT PANCREATIC NECK INJURY. Vietnam Medical Journal, 525(2). https://doi.org/10.51298/vmj.v525i2.5171

EVALUATION THE RESULT OF DIAGNOSIS AND TREATMENT OF BLUNT PANCREATIC NECK INJURY

Nguyên Hưng Thái 1,
1 k hospital

Main Article Content

Abstract

Study aim: We reported  our retrospective study  aim at  evaluating  the clinical feature  of  blunt pancreatic neck injury and  the result  of its surgical and medical treatment. Patient and method: Restrospective study. + Time From 2012 to 2017. Result: There were 24 patients of blunt pancreatic neck  injury were observed, male 23 patients (95,8%), female 1 patient (4,2%), the mean age: 30,2. The reason for pancreatic injury: traffic acident: 66,7%, labour accident: 4,1%, other: 29,2%. Clinic feature: abdominal pain: 100%, elevation of amylasemie: 95,8%. Ultrasonography only detected 37,5% pancreatic injury. Abdominal CTscan detected 100% of pancreatic injury. 66,7% of the patients were performed emergency operation, 12,5% were elective  operation, observation and medical treatment were 20,8%. The surgical procedure included: 57,9% were sutured the proximal stump of pancreatic head  and  anastomosis  pancreatico-jejunostomy of the distal stump (Roux en Y). 15,8% were peformed left pancreatectomy, 15,8% were performed pancretico-gastrostomy  anastomosis of the pseudocyst of pancreas, 2 patients were performed drainage and necrosectomy. The complications: 1 had abscesses (Drainage under ultrasound), 2 had pancreatic fistulas (one had other operation pancreatic psuedocyst gastrostomy 3 months later, the other: the pancreatic fistulas stopped spontaneously by mediacal treatment). Conclusion: Blunt pancreatic neck injury are serious lesion due to traffic accident 66,7%, labour accident 4,1% and other accident 29,2%. The main symptoms were abdominal pain, raise of white cell and amylasemie. Computerzied tomography is  the good choise for the diagnosis of blunt pancreatic  injury (high precision). Abdominal surgery was the principal method for its treatment included: Left pancreatectomy, suture of the proximal pancreatic stump and anastomosis pancreatico-jejunostomy (the distal stump) or external drainage and  pancreatic necrosectomy. We had no death post operation. The complications were mainly pancreatic fistulas with low  proportion.

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