XXXX from @entity130 .

@entity1 @entity660 @entity542 @entity9007 @entity3511 @entity130
@entity660 from @entity130 are infrequent, and their diagnosis and management can be extremely difficult. Over the past 10 years we treated 13 @entity1 with major @entity660 from @entity130 . Twelve had been involved in motor vehicle collisions, none of whom were wearing seat belts. One @entity1 was injured in an assault. Only five @entity1 had physical findings suggesting @entity3511 . Serum amylase levels were elevated in seven of the nine @entity1 (78%) in whom this test was obtained. Computed tomography scans demonstrated @entity660 in three of the four @entity1 in whom it was performed. The five @entity1 in whom peritoneal lavage was performed had free intraperitoneal blood from @entity3511 . One injury was diagnosed by ultrasound. Injuries were equally distributed throughout the pancreas, with two @entity130 in the head, three in the body, five in the tail, and three with @entity130 in both the head and the body. Five @entity1 had @entity130 . All @entity1 underwent celiotomy. Eight @entity1 required no operative management of their @entity660 other than drainage. Injury Severity Score averaged 28.5 +/- 2.6 (mean +/- standard error), and mean hospital stay was 31 +/- 9.8 days. One @entity1 with delayed diagnosis of a @entity660 developed a @entity9007 , but all other complications and prolonged hospitalizations were due to @entity542 , chest, other abdominal organs, or extremities. All @entity1 survived. The diagnosis of blunt @entity660 requires a high index of suspicion, and diagnostic studies may demonstrate only subtle signs of injury. Most @entity130 can be managed by localized resection and/or drainage.(ABSTRACT TRUNCATED AT 250 WORDS)
