RESUMEN
A survey of the main series in the world literature and personal data concerning injuries to the pancreas is followed by the suggestion that the risk of pseudocyst or pancreatitis means that in all cases where injury to the pancreas is suspected, and resolution is slow, laparotomy must be performed, coupled with careful exploration of the lesser omentum and precise evaluation of possible lesions, prior to suitable surgical management. Medical therapy is also of prime importance. Its main feature is the administration of a protease inhibitor to prevent pre- and post-operative enzymatic toxaemia.
Asunto(s)
Páncreas/lesiones , Adulto , Preescolar , Drenaje , Duodeno/cirugía , Humanos , Yeyuno/cirugía , Masculino , Páncreas/cirugía , Pancreatectomía , Fístula Pancreática/cirugía , Cuidados Posoperatorios , Cuidados Preoperatorios , Inhibidores de Proteasas/administración & dosificación , Inhibidores de Proteasas/uso terapéutico , Heridas por Arma de Fuego/cirugíaRESUMEN
The Authors followed 29 patients, hospitaled with a diagnosis of pancreatitis. They all presented the same sympotomatology and a considerable increase of the serum amylase ad urinary amylase. The examination of the ratio between the clearance of amylasis and creatinine permitted to make a differential diagnosis for 8 cases (4rd group) that were nothing but peptic ulcera. Such a diagnosis was confirmed by the radiological contrastographic examination or by the intraoperative report. So if the ratio between the clearance of amylase and creatinine is normal we must think about a pathological situation were the iperamylasemia has a pathogenetic cause different from pancreatitis.