CT DIAGNOSIS OF BLUNT PANCREATIC TRAUMA - IMPORTANCE OF DETECTING FLUID BETWEEN THE PANCREAS AND THE SPLENIC VEIN

OBJECTIVE. The purpose of this study was to determine the value of det ecting fluid between the splenic vein and the pancreas on CT scans in the diagnosis of pancreatic injury after blunt abdominal trauma. MATER IALS AND METHODS. We retrospectively reviewed the abdominal CT scans o f 10 patients with surgical- or autopsy-proved pancreatic injury after blunt abdominal trauma. The finding of fluid interdigitating between the pancreas and the splenic vein was then studied along with the repo rted CT features of pancreatic injury. These included intraperitoneal fluid, fluid in the lesser sac, extraperitoneal fluid, pancreatic edem a or hematoma, and thickening of the anterior renal fascia. RESULTS. T he CT scans of all 10 patients reviewed showed abnormalities suggestin g pancreatic injury. Only 40% of patients showed all of the findings r eported in the literature. Fluid interdigitating between the splenic v ein and the pancreatic parenchyma was seen on CT scans in 90%. CONCLUS ION. Our experience suggests that fluid between the splenic vein and t he pancreas is a helpful CT finding for the diagnosis of pancreatic in jury after blunt abdominal trauma. This finding was easy to recognize and in the proper clinical setting directs attention to additional sub tle findings of pancreatic injury.