Pancreas: Pancreatic injuries secondary to blunt trauma usually the crushing force of a steering wheel are uncommon, and are rarely seen as isolated injuries (in the institute study, only one was encountered). While injury due to penetration may be detected mote readily, blunt pancreatic injury is usually only discovered when the abdomen is explored for splenic and other suspected pathologies.
Early detection of pancreatic injury is often made difficult because the onset of symptoms epigastric pain and tenderness may be delayed for several hours, or even longer if the patient’s level of consciousness is depressed. And because pancreatic bleeding post-injury occurs in the retroperitoneal space, it cannot usually be detected by peritoneal lavage. Other warnings, however, include: