Search

Background: We aimed to study the frequency, management, and outcomes of patients with blunt pancreatic trauma. Methods: We reviewed the medical records for all patients admitted with pancreatic injuries between 2011 and 2017 at the only level 1 trauma center in the country. Results: There were 71 patients admitted with pancreatic trauma (0.6% of trauma admissions and 3.4% of abdominal injury admissions) with a mean age of 31 years. Sixty-two patients had pancreatic injury grade I-II and 9 had grade III-IV. Thirty-eight percent had GCS 16. The level of pancreatic enzymes was significantly proportional to the grade of injury. Over half of patients required a laparotomy, of them 12 patients had an intervention on the pancreas. Eight patients developed complications related to pancreatic injuries ranging from pancreatitis to pancreatico-cutaneous fistula while 35% developed hemorrhagic shock. Mortality was 31% and regardless of the grade of injury, the mortality was associated with high ISS, low GCS and presence of hemorrhagic shock. Conclusion: Pancreatic injuries following blunt trauma are rare and the injured subjects are usually young male. However, most injuries are of low-grade severity. This study shows that shock, higher ISS and lower GCS are associated with worse in-hospital out-comes. Non-operative management may suffice in patients with lower grade injuries, which may not be the case in patients with higher grade injuries unless carefully selected

Introduction: Non-palpable breast lesions are very difficult to excise accurately without wire localization. We present a case where the wire had migrated into the axilla and noticed during surgery. Case presentation: A 55-year-old lady was admitted for wire guided surgical excision of a clinically non-palpable right breast lesion. Before starting the surgery it was noticed that the wire had migrated and confirmed by X-ray to be in the axilla. Multiple attempts to retrieve it failed and procedure was aborted. CT scan was done next day to localize the wire and patient was brought back for surgery the next day. We were successful in retrieval of wire and tumor which was confirmed by histopathology later. Conclusion: Surgeons and radiologists should be well aware of this complication and additional measures should be taken to secure the wire.