ULTRASOUND FINDINGS IN PATIENTS WITH PANCREATIC TRAUMA AND THEIR CORRELATION WITH COMPUTED TOMOGRAPHY

Abstract

INTRODUCTION: Pancreatic trauma is a rare event that is characterized by being difficult to diagnose. This is due to its retroperitoneal and intimate location with several important structures, making its clinical picture extremely nonspecific, being associated with great morbidity and mortality. Considering this, diagnostic imaging aims to try to reduce late damage control and, therefore, improve the outcome of patients. Among the diagnostic methods, ultrasonography and computed tomography stand out. OBJECTIVE: To study the ultrasound findings in the diagnosis of pancreatic trauma and their correlation with computed tomography. METHODOLOGY: It is a narrative review with emphasis on the collection of images. The databases were MEDLINE via PubMed, LILACS and Scielo via VHL (Virtual Health Library). The health descriptors (MeSH terms) in English are “pancreatic trauma”, “ultrasonography”, “ultrasound”, “computed tomography”, “diagnostic imaging”, in the following search strategy: (pancreatic trauma) AND (ultrasonography OR ultrasound OR computed tomography OR diagnostic imaging). Studies (clinical trials, pictorial essays, literature reviews, among others) that had images of diagnostic methods that were in accordance with the research objective and available online in full text, published in the last 20 years, in English, Spanish and Portuguese. RESULTS AND DISCUSSION: In the diagnosis of pancreatic trauma, it is known that ultrasound, despite being the screening test in trauma patients, has little accuracy in detecting parenchymal injuries, depending on the location of the lesion. In addition, the use of contrast improves the accuracy for detecting parenchymal lesions, allowing the detection of changes in perfusion (anechoic or hypoechoic region), contrast extravasation, edema, irregularities in the pancreatic borders, visualization of peripancreatic fluids. Computed tomography is considered the gold standard for diagnosing pancreatic trauma. Lesions are usually seen as a heterogeneous region accompanied by a region of low attenuation, in addition to an area of hypoperfusion when using intravenous contrast. CONCLUSION: Ultrasonography is accurate in diagnosing traumatic pancreas lesions; however, with nonspecific or subtle findings, many times. The use of contrast plays a very important role in the initial detection of pancreatic trauma, even in small lesions. Computed tomography stands out in this diagnosis, as it was possible to observe in all the cases presented.