Blunt trauma injuries to the pancreas are rare but are associated with significant overall mortality and a high complication rate.\nMotor vehicle collisions are the leading cause of blunt pancreatic trauma, followed by falls, and sports injuries. We discuss the\ndecision-making process used during the clinical courses of 3 patients with life-threatening blunt pancreatic injuries caused by\ntraumatic falls. We also discuss the utility of the American Association for the Surgery of Trauma Organ Injury Scale (AAST-OIS),\nwhich provides a system for grading pancreatic trauma. Retrospectively, the cases reviewed were classified as AAST-OIS grade II,\nIII, and IV in each one patient. Although the nonoperative approach was initially preferred, surgery was required in each case due\nto pseudocyst formation, pancreatic necrosis, and posttraumatic pancreatitis. In each case, complete healing was achieved through\nexploratory laparotomy with extensive lavage and placement of abdominal drains for several weeks postoperatively. These cases show\nthat nonoperative management of pancreatic ductal trauma results in poor outcomes when initial therapy is less than optimal.
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