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Pancreatitis After a Fall: Causes, Symptoms & What to Do

Traumatic Pancreatitis

Blunt abdominal trauma (falls, motor vehicle crashes, handlebar injuries, assaults) can compress the pancreas against the vertebral column, causing contusion, laceration, or duct disruption. This triggers premature trypsin activation → autodigestion → acute pancreatitis.

Timing

Symptoms may appear immediately or be delayed 24–72 hours post-injury, complicating diagnosis.

Key Symptoms

  • Epigastric pain, radiating to back (classic)
  • Nausea, vomiting
  • Fever, tachycardia
  • Abdominal tenderness, guarding, distension
  • Bruising (Grey Turner's sign: flanks; Cullen's sign: periumbilical) — late, severe

Diagnostic Workup

  • Serum lipase (preferred) or amylase >3× upper limit of normal
  • Contrast-enhanced CT abdomen (gold standard): assesses necrosis, fluid collections, duct injury
  • MRCP/ERCP if duct disruption suspected

Management

  • Aggressive IV hydration (lactated Ringer's)
  • Analgesia (opioids; avoid NSAIDs if renal concern)
  • Early enteral nutrition (nasojejunal) if tolerated
  • Monitor for complications: necrosis, infected pseudocyst, pseudaneurysm, compartment syndrome
  • Surgery/endoscopy for duct disruption, infected necrosis, or hemorrhage

Urgent Action

After significant abdominal trauma, seek emergency evaluation even if initial pain seems mild. Delayed diagnosis increases morbidity.

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