J Korean Radiol Soc.  1997 Apr;36(4):645-649.

Usefulness of CT and ERCP in Traumatic Pancreatic Injury

• Kwon TS
• Kim YJ
• Cho KS
• Park JW
• Kim DJ
• Sung KJ
• Park JS
• Kim JJ
• Ko SM
• Jang YS

Abstract

PURPOSE
To evaluate the usefulness of CT and ERCP in the diagnosis of traumatic pancreatic injury, and the degree of such injury.
MATERIALS AND METHODS
Using CT (n=30) and ERCP (n=8), we retrospectively analyzed 30 cases of surgically proven traumatic pancreatic injury. Both CT and surgical findings were evaluated according to intra-and extra- pancreatic change and assigned to one of five grades, according to their pattern. ERCP findings were categorized as normal mass effect, parenchymal staining, or extravasation of contrast material. In all 30 cases CT and ERCP findings were compared with surgical findings.
RESULTS
Pancreatic enlargement was the most common finding of intrapancreatic change in 21(67%) cases (67%). In 20 of 30 cases, there was good correlation between the CT grade and surgical grading. Of the remaining ten cases, seven cases (23%) were underestimated and three(10%) were overestimated. CT grade III or IV suggest pancreatic duct injury ; in two of 13 cases with this grade, such injury was not seen on surgery, however. Of the eight cases in which ERCP was performed, two were normal, one showed mass effect, one showed parenchymal staining, and four, all of which showed pancreatic duct injury on surgery, showed extravasation of contrast material. Two of these four cases were CT grade II, but on surgery, proven duct injury was seen.
CONCLUSION
In cases of pancreatic duct injury, ERCP is superior to CT; where such injury is suspected, it should therefore be used to determine whether or not the injury is in fact present.

Keyword

Pancreas, CT; Pancreas, injuries; Endoscopic retrograde cholangiopancreatography (ERCP)

MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde*
Diagnosis
Pancreatic Ducts
Retrospective Studies