A rare case of isolated pancreatic injury in blunt trauma abdomen
DOI:
https://doi.org/10.18203/2349-2902.isj20220644Keywords:
Blunt trauma abdomen, Isolated pancreatic injury, Pancreatic duct injuryAbstract
Injury to the pancreas by a blunt trauma is very rare and accounts for less than 2% of all abdominal injuries. It can be acute or delayed presentation. CT abdomen is the major imaging method in the diagnosis of abdominal visceral injuries. We can confirm pancreatic main duct injuries with magnetic Resonance Cholangiopancreatography (MRCP) or ERCP by contrast extravasation. ERCP has also been used therapeutically with transpapillary stunting across the pancreatic duct disruption or simply across the sphincter of Oddi aiming at a reduction of the intrapancreatic pressure gradient. There are several surgery options for which can be employed to manage this injuries.
References
Oteiza F, Diaz de Liaño A, Ciga MA. Isolated blunt pancreatic rupture diagnosed by computerized axial tomography. Cir Esp. 2003;74(5):296-8.
Tsai MT, Sun JT, Tsai KC. Isolated traumatic pancreatic rupture. Am J Emerg Med. 2010;28(6):745.e3-4.
Holalkere NS, Soto J. Imaging of miscellaneous pancreatic pathology (trauma, transplant, infections and deposition). RadiolClin N Am. 2012;50(3):515-28.
Fisher M, Brasel K. Evolving management of pancreatic injury. CurrOpinCrit Care. 2011;17(6):613-7.
Peitzman AB, Richardson JD. Surgical treatment of injuries to the solid abdominal organs: a 50-year perspective from the Journal of Trauma. J Trauma. 2010;69(5):1011-21.
Kreis ME, Albertsmeier M, Graser A. Novel surgical technique for complete traumatic rupture of the pancreas: a case report. J Med Case Rep. 2011;5:456.
Govaert MJ, Ponsen KJ, de Jonge L. Fracture of the pancreas in two patients after a go-kart accident. HPB (Oxford). 2001;3(1):3-6.
Moore EE, Moore FA. American Association for the Surgery of Trauma Organ Injury Scaling: 50th anniversary review article of the Journal of Trauma. J Trauma. 2010;69(6):1600-1.
Bradley EL 3rd, Young PR Jr, Chang MC. Diagnosis and initial management of blunt pancreatic trauma. Ann Surg. 1998;227(6):861-9.
Stawicki SP, Schwab CW. Pancreatic trauma: demographics, diagnosis and management. Am Surg. 2008;74(12):1133-45.
Healey AJ, Dimarakis I, Pai M. Delayed presentation of isolated complete pancreatic transection as a result of sport-related blunt trauma to the abdomen. Case Rep Gastroenterol. 2008;2(1):22-6.
Sato M, Yoshii H. Re-evaluation of ultrasonography for solid-organ injury in blunt abdominal trauma. J Ultrasound Med. 2004;23(12):1583-96.
Gillams AR, Kurzawinski T, Lees WR. Diagnosis of duct disruption and assessment of pancreatic leak with dynamic secretin-stimulated MR cholangiopancreatography. Am J Roentgenol. 2006;186(2):499-506.
Wagner M, Gloor B, Ambühl M. Roux-en-Y drainage of the pancreatic stump decreases pancreatic fistula after distal pancreatic resection. J Gastrointest Surg. 2007;11(3):303-8.