Background: Isolated pancreatic injuries are rare. There are no clear guidelines on management. Traditionally all low grade injuries are treated nonoperatively whereas high grade injuries are treated surgically. Recently a more conservative less aggressive approach is preferred. The aim of the study is to present outcomes of pancreatic trauma patients treated conservatively.

Methods: In this retrospective study, all patients admitted with isolated pancreatic injury between June 2009 and June 2017 was included. Outcomes of their management were analyzed.

Results: A total of 28 patients were analyzed. Majority were males (85%) with the mean age of 32 years and were caused by blunt trauma. 68% were Grade I & II and the rest were grade III & IV. All Grade I & II patients were managed nonoperatively without any morbidity. All Grade III patients underwent distal pancreatectomy without splenectomy. All Grade IV injuries were considered for initial nonoperative management. All these patients had either pseudocyst or fistula formation which was managed surgically without resection. No mortality was reported.

Conclusions: A more conservative less aggressive approach is safe and feasible in high grade (Grade IV) pancreatic injuries with expectant formation of pseudocyst or fistula which can be managed by nonresectional procedures with less morbidity and mortality.