pancreatic trauma injury grading

Pancreatic
trauma injury grading • Pancreatic trauma grading (diagrams) - Ganzer Fall bei Radiopaedia
Skalski M, Pancreatic trauma grading (diagrams). Case study, Radiopaedia.org (Accessed on 21 Sep 2023) https://doi.org/10.53347/rID-54873 • CC by-nc-sa 3.0 (modified)
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who fell off a table and then had the table fall on to them. Axial CT with contrast of the abdomen shows a heterogenous appearance to the pancreatic head (middle left and below left) which is also appreciated on the coronal image (above right) just medial to the contrast filled duodenum. There was a large amount of free fluid in the pelvis (below right)The diagnosis was contusion of the pancreatic head.
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A number of pancreatic injury grading systems have been proposed.

Classifications

American Association for the Surgery of Trauma (AAST)
  • grade 1: hematoma with minor contusion/laceration but without duct injury
  • grade 2: major contusion/laceration but without duct injury
  • grade 3: distal laceration or parenchymal injury with duct injury
  • grade 4: proximal (i.e. to the right of the superior mesenteric vein) laceration or parenchymal injury with an injury to bile duct/ampulla
  • grade 5: massive disruption of the pancreatic head

N.b. advance one grade for multiple injuries up to grade III.

Wong et al. 

A more simple method for grading severity on CT in pancreatic injury proposed by Wong et al.  is:

  • grade A: pancreatitis or superficial laceration only
  • grade B
    • BI: deep laceration involving pancreatic tail
    • BII: complete transection of pancreatic tail
  • grade C
    • CI: deep laceration involving pancreatic head
    • CII: complete transection of pancreatic head
Siehe auch:
Assoziationen und Differentialdiagnosen zu Pankreastrauma Gradeinteilung:
Pankreastrauma
 
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Pankreaskontusion
 
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