As. Fulcher et al., Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: Preliminary findings, J TRAUMA, 48(6), 2000, pp. 1001-1007
Background: The purpose of this study was to determine the utility of magne
tic resonance cholangiopancreatography (MRCP) in the evaluation of pancreat
ic duct trauma and pancreas-specific complications.
Methods: Ten hemodynamically stable patients with clinically suspected panc
reatic injury related to blunt abdominal trauma (n = 8), penetrating trauma
(n = 1), or iatrogenic trauma (n = 1) underwent MRCP. Two abdominal radiol
ogists conducted a review of the MRCPs to assess for the presence or absenc
e of pancreatic duct trauma and pancreas-specific complications such as pse
udocysts, The MRCP findings were correlated with endoscopic retrograde chol
angiopancreatograms (n = 2), surgical findings (n = 1), computed tomographi
c scans (n = 10), and with clinical, biochemical or imaging follow-up (n =
10),
Results: Diagnostic quality MRCPs were obtained in each of the 10 patients.
A mean imaging time of 5 minutes was required to perform the MRCPs, Pancre
atic duct injuries were detected in four patients; pseudocysts were detecte
d in three of these four patients. The pancreatic duct injuries in three pa
tients were acute or subacute, In one of the three patients, disruption of
a side branch of the pancreatic duct diagnosed with MRCP was not detected w
ith endoscopic retrograde cholangiopancreatography but was confirmed surgic
ally. In the fourth patient, the pancreatic duct injury was chronic; MRCP r
evealed a posttraumatic stricture in this patient who had sustained blunt a
bdominal trauma 17 years previously. In the remaining six patients, pancrea
tic duct trauma was excluded with MRCP. The information derived from the MR
CPs was used to guide clinical decision-making in ail 10 patients.
Conclusions: MRCP enables noninvasive detection and exclusion of pancreatic
duct trauma and pancreas-specific complications and provides information t
hat may be used to guide management decisions.