ROLE OF 128 SLICE MDCT IN PANCREATIC TRAUMA DIAGNOSIS AND MANAGEMENT

Abstract

Aims and Objectives:This study aimed to detail how multi-detector computed tomography (MDCT) can be utilised to the study diagnosis of pancreatic trauma and its management. Material and Methods:This Hospital-based prospective study was carried out over 10 months from December 2020 to SEP 2021 at the Department of Radiodiagnosis, Narayana medical college, Nellore. 30 patients with pancreatic injury were included in study. All patients underwent Contrast enhanced computed tomography abdomen on128 slice CT(GE OPTIMA 660).Grading of pancreatic injury done using American Association for the surgery of trauma organ injury scale .One patient underwent MRI abdomen and MRCP. 20 patients are treated conservatively. 10 out of 30 patients underwentsurgery.Intraoperative findings noted. Results: 1. According to American Association for the surgery of trauma organ injury scale 19/30 patients are of grade I &grade II injury. 6/30 in grade III and 5/30 were grade IV injuries. 2. Grade I &II patients were managed conservatively and improved remarkably on followup. 3. Grade III&IV patients underwent surgery and CT findings are confirmed intraoperatively. 4. 6 patients with grade III injury undergone Distal pancreatectomy + Splenectomy and 4 patients undergone Spleen preserving Distal Pancreatectomy. 5. Grade IV patients initially managed conservatively in which 4 patients developed pseudocyst they were treated with cystogastrostomy and one patient developed fistula .This fistula was initially controlled with Percutaneous catheter drainage followed by roux -en- y fistulojejunostomy. Conclusion: 1. CT represents an accurate tool for diagnosing pancreatic trauma, it provides useful information to plan therapeutic approach .