A survey of the main series in the world literature and personal data concerning injuries to the pancreas is followed by the suggestion that the risk of pseudocyst or pancreatitis means that in all cases where injury to the pancreas is suspected, and resolution is slow, laparotomy must be performed, coupled with careful exploration of the lesser omentum and precise evaluation of possible lesions, prior to suitable surgical management. Medical therapy is also of prime importance. Its main feature is the administration of a protease inhibitor to prevent pre- and post-operative enzymatic toxaemia.