We reviewed pancreatic injury (PI) diagnostics, including our experience with PI. Positive physical findings do not always indicate PI due to abdominal findings often masked by other abdominal injury. Serum amylase levels (SAL) are not reliable or significant in diagnosing early-stage PI, nor is peritoneal lavage nor computed tomography (CT), which may not show accurately whether a main pancreatic duct is injured, even in highly sensitive scanning. Endoscopic retrograde pancreatography (ERP) may reliably detect operative adaptation, avoiding negative laparotomy, although early adoption of ERP remains controversial. The utility of helical CT and magnetic resonance imaging (MRI) also show promise, indicating the need for further detailed study of these different modalities in diagnosing PI.

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