Findings indicative of pancreatic injury (hard signs):
(1) active bleeding involving the pancreas
(2) pancreatic hematoma
(3) pancreatic laceration
(4) heterogenous focal or diffuse enlargement of the pancreas
(5) heterogenous focal or diffuse pancreatic edema
(6) low attenuation of the pancreas
Fluid accumulations suggestive of pancreatic injury (soft signs):
(1) retroperitoneal fluid
(2) free intraperitoneal fluid
(3) fluid in the lesser sac
(4) fluid in the transverse mesocolon
(5) fluid surrounding the superior mesenteric artery
(6) fluid between the splenic vein and the posterior pancreas
Other findings suggestive of pancreatic injury (soft signs):
(1) edema of the peripancreatic fat
(2) inflammation of the peripancreatic fat
(3) inflammation of the mesentery
(4) thickening of the anterior perirenal fascia
Performance:
• Imaging studies may fail to detect pancreatic injury.
• If pancreatic injury is detected, then it may not always indicate the severity.
