Case p  -Blunt abdominal trauma causing pancreatitis

There is a small amount of hemoperitoneum around the tip of the liver, in the right paracolic gutter, and within the pelvis.  There is edema and indistinctness in the head of the pancreas.  There is some surrounding stranding which extends into the root of the mesentery. There are no fractures seen through the pancreas.  The adjacent duodenum appears normal.  There are no regions of active contrast extravasation.

If this were not a trauma patient the findings would indicate pancreatitis.  In a trauma setting the findings indicate either pancreatic contusion or  pancreatitis.  Trauma is the leading cause of pancreatitis in children and can also be seen in adults. 

Clinically, the amylase was normal and the lipase was slightly elevated at 80.  The patient recovered without intervention.  The diagnosis is pancreatic head contusion vs pancreatitis.

Notice the bibasilar atelectasis versus consolidation.  It is not possible to exclude aspiration.

Did you notice the prostate calcifications?

Key points

• Pancreatitis can be secondary to trauma and this is common in kids.
• Pancreatic and retroperitoneal duodenal injuries are common in belted MVC patients.  The pancreas and duodenum get squished between the seatbelt and spine.