A population-based study of pancreatic trauma in Scotland

Introduction: The aim of this population-based study was to assess the incidence, mechanisms, management and outcome of patients who sustained pancreatic trauma in Scotland over the period 1992-2002. Methods: The Scottish Trauma Audit Group database was searched for details of any patient with pancreatic trauma. Results: About 111 of 52,676 patients (0.21%) were identified as having sustained pancreatic trauma. The male-to-female ratio was 3:1, with a median age of 32 years. Blunt trauma accounted for 66% of injuries. Road traffic accidents were the most common mechanism of injury (44%), followed by assaults (35%). Thirty-four patients (31%) were haemodynamically unstable on arrival at hospital. Pancreatic trauma was associated with injuries to the chest (56%), head (30%) and extremities (30%); 73% of patients had other intra-abdominal injuries. Of those who left the emergency department alive, at least 77% required a laparotomy. The mortality rate (46%) was directly proportional to the number of injuries sustained (P < 0.05) and was higher in patients with increasing age (P < 0.05), haemodynamic instability (P < 0.05) and blunt trauma (P < 0.05). Conclusions: Pancreatic trauma is rare in Scotland but is associated with significant mortality. Outcome was worse in patients with advanced age, haemodynamic instability, blunt trauma and multiple injuries.