A client was brought to the ED due to an abdominal trauma caused by a motorcycle accident. During the assessment, the client complains of epigastric pain and back pain. Which of the following is true regarding the diagnosis of pancreatic injury?
A. Redness and bruising may indicate the site of the injury in blunt trauma
B. The client is symptom-free during the early post-injury period
C. Signs of peritoneal irritation may indicate pancreatic injury
D. All of the above
Correct Answer: D. All of the above
Blunt injury resulting from vehicular accidents could cause pancreatic injury. Redness, bruising in the flank and severe peritoneal irritation are signs of a pancreatic injury. The client is usually pain-free during the early post-injury period, hence a comprehensive assessment and monitoring should be done.
Option A: Pancreatic injury is hidden in the shadows of coexisting intraabdominal injuries and its inherent retroperitoneal location. Symptoms of radiating epigastric pain to the back, nausea, and vomiting are also seen with the more commonly injured adjacent viscera. An abdominal exam is reported to have a false negative rate of 34% on initial evaluation.
Option B: Traumatic pancreatitis can be a difficult diagnosis to make and requires meticulous investigation. Damage to the pancreas is not very common and is seldom a solitary insult. As the signs and symptoms are nonspecific, a high index of suspicion is necessary to prevent delayed diagnosis.
Option C: Other complications include pancreatic pseudocyst which is a circumscribed collection of enzymes, blood, and necrotic tissue. Less frequent complications include peritonitis, intestinal obstruction, and gastrointestinal bleeding. Pancreatic trauma can disrupt the endocrine function for patients as well.
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