Affecting Factors to the Abdominal Physical Examinations in the Patients with Blunt Pancreatic Injury

Tsunemasa Takishima¹⁾, Yasushi Asari¹⁾, Mitsuhiro Hirata¹⁾, Akira Kakita²⁾

¹⁾Department of Emergency and Critical Care Medicine, ²⁾Department of Surgery, Kitasato University, School of Medicine

To clarify the factors affecting to the abdominal physical examinations in patients with blunt pancreatic injury, we reviewed 59 patients whom we experienced during the past 12 years and 10 months. Abdominal pain was obvious in 56 (94.9%) of 59 patients, 20 (90.9%) of 22 and 36 (97.3%) of 37 in those with isolated pancreatic injury (Isolated group) and those with intraabdominal associated injuries (Complicated group), respectively. Pain was located within the epigastric area in 33 (58.9%) of 56 whose abdominal pain was obvious. This tendency was significantly higher in the Isolated group than the Complicated group. Peritoneal irritation was obvious in 33 (55.9%) of 59 patients, and this frequency in patients with type 1 injury (contusion) was signficantly lower than that in patients with type 2 injury (laceration) and type 3 injury (ductal injury). The frequency of the peritoneal irritation in type 1 patients in the Isolated group was significantly lower than that in type 3 patients in the Isolated group and type 1 patients in the Complicated group. In conclusion, the potential location of abdominal pain was within the epigastric area in patients with blunt pancreatic injury, but intraabdominal associated injuries altered the location of pain. Postive signs of peritoneal irritation were a high index of pancreatic ductal injuries or intraabdominal associated injuries.

Key words
blunt pancreatic injury, abdominal physical examinations, pancreatic ductal injury, intraab dominal associated injury

Reprint requests
Tsunemasa Takishima Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine
1-15-1, Sagamihara, 228 JAPAN

Accepted
May 11, 1994

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