Traumatic Pancreatitis

I recently had a patient that we decided had traumatic pancreatitis. The attending physician had mentioned he hadn't seen a case of this in a long time, and I'm thinking I haven't seen a case prior to this. That sort of made me think, was it more common years ago? This phenomenon isn't something I see even on occasion, or that I can think of.

Our patient had no external signs of injury and the trauma workup was essentially negative. There was some "haziness" at part of the pancreas on CT scan (can't remember if it was the head or tail), but no injury called on the read. The only thing was the patient had elevated pancreatic enzymes. In looking at some research, traumatic pancreatitis is frequently the result of trauma to the epigastrum, such as impact from a steering wheel or handle bars. If I remember, our patient was assaulted/kicked, but to the back, not abdomen.

The process is thought to involve the rupture of minor components of the pancreatic duct system, consequently releasing the enzymes. This would account for our patient's elevated levels. Management is non-operative and it will resolve naturally. From my experience, this isn't something encountered everyday, nor is it something of major concern. However, it was something new that I thought I'd share. Maybe someone else will have a case of traumatic pancreatitis soon.