Based on Soltani & Jurkovich, Diagnosis and Management of Pancreatic Trauma: What You Need to Know (J Trauma Acute Care Surg, 2025)
Suspect pancreatic injury with a direct epigastric blow (handlebar, steering wheel, seatbelt) or penetrating trauma to the upper abdomen or back. The exam is often unreliable — classic peritoneal signs may be absent despite a major injury, and the Grey-Turner sign is rare. Nausea, vomiting, and epigastric pain may be the only clues.