Pancreatic Disorders & Therapy
Open Access
ISSN: 2165-7092
ISSN: 2165-7092
Bradley J Phillips
Trauma Response and Transfer LLC, USA
Keynote: Pancreat Disord Ther
A penetrating injury to the pancreas reportedly occurs in 1.1% of trauma patients. Krige has reported an overall mortality of 15.7% in over 400 patients with a penetrating injury to the pancreas and noted that injury grade and repeat laparotomy were significant predictors of morbidity. Akhrass found a mortality of 16.6% in a series of 72 patients but interestingly death was not related to mechanism or grade of injury. Pancreatic injuries are often masked by severe associated injuries, thus necessitating a high index of suspicion for a timely and accurate diagnosis. Due to difficulty in diagnosis and treatment, it is essential that physicians are cognizant of the predictors of morbidity and mortality associated with penetrating pancreatic injuries. Failure to recognize pancreatic injury, especially to the main pancreatic duct�??the sine qua non of severe pancreatic trauma�??can increase morbidity and mortality. This study is the second in our series describing �??Tiger Country�?� and the first to describe penetrating pancreatic injuries using the National Trauma Data Bank to document AAST-OIS grade as a statistically significant predictor of mortality. Overall mortality in this series was 16.9% and was consistent over the 5-year study period. Using Haider�??s recommendations, we controlled for covariance and found that decreasing SBP, decreasing GCS, increasing pulse, increasing ISS and increasing OIS grade all predicted the likelihood of death following penetrating pancreatic injury. These predictors have not been previously documented in the world�??s literature. Based on our findings, we believe that the AAST-OIS grades appropriately indicate the relative severity and mortality of penetrating trauma to the pancreas and the associated constellation of injuries.
Bradley J Phillips completed his M.D. from Michigan State University and surgical residency at Maricopa Medical Center in Phoenix, Arizona. He then went on to complete three fellowships – the first one was at Harvard Medical School-Brigham & Women’s Hospital in Cardiothoracic Research, the second was at Boston University in Trauma-Critical Care and the third was at Shriner’s Hospital for Children-Galveston in Pediatric Burns. He has worked in multiple faculty positions and directorships including the role of Chief Surgeon at the U.S. Embassy in Baghdad during the ISIS invasion of Iraq. He is now the Chief of “Trauma Response and Transfer LLC”, a private contract-based company. He has published more than 100 papers in respected journals and has served as an Editor-in-Chief of an academic textbook entitled “Pediatric Burns”.
E-mail: bjpmd02@gmail.com