The online version of this article (doi:10.1186/1752-1947-8-173) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
AV and VK designed the report; AV and GF were attending doctors for the patient; AV and AP performed the endoscopic procedure; GF and GP organized the report; AV and VK wrote the paper and GP and AP gave the final approval. All authors read and approved the final manuscript.
Pancreatic injury is uncommon and the management remains controversial. The integrity of the main pancreatic duct is considered the most important determinant for prognosis.
A 19-year-old Greek man was referred to our tertiary referral centre due to blunt abdominal trauma and an associated grade III pancreatic injury. He was haemodynamically stable and his initial treatment was conservative. Due to deterioration in his clinical symptomatology he underwent an endoscopy 20 days postinjury, where a stent was placed in the proximal pancreatic duct remnant and a bulging fluid collection of the lesser sac was drained transgastrically. He made an uneventful recovery and remains well 7 months postinjury, but a stricture with upstream dilatation of his main pancreatic duct has developed.
The clinical status of the patient rather than the grade of pancreatic injury should be the principal determinant to guide treatment. Endoscopic stenting and drainage is an attractive minimally invasive procedure and it may obviate the need for surgery. However, further investigation is required regarding the safety and outcome.
Authors’ original file for figure 113256_2013_2866_MOESM1_ESM.tiff
Authors’ original file for figure 213256_2013_2866_MOESM2_ESM.tiff
Authors’ original file for figure 313256_2013_2866_MOESM3_ESM.jpeg
Authors’ original file for figure 413256_2013_2866_MOESM4_ESM.tif
Authors’ original file for figure 513256_2013_2866_MOESM5_ESM.tiff
Jurkovich GJ, Carrico CJ: Pancreatic trauma. Surg Clin North Am. 1990, 70: 575-593. PubMed
Phelan HA, Velmahos GC, Jurkovich GJ, Friese RS, Minei JP, Menaker JA, Philp A, Evans HL, Gunn ML, Eastman AL, Rowell SE, Allison CE, Barbosa RL, Norwood SH, Tabbara M, Dente CJ, Carrick MM, Wall MJ, Feeney J, O'Neill PJ, Srinivas G, Brown CV, Reifsnyder AC, Hassan MO, Albert S, Pascual JL, Strong M, Moore FO, Spain DA, Purtill MA: An evaluation of multidetector computed tomography in detecting pancreatic injury: results of a multicenter AAST study. J Trauma. 2009, 66: 641-646. 10.1097/TA.0b013e3181991a0e. CrossRefPubMed
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: 499-506. 10.2214/AJR.04.1775. CrossRef
- Complete traumatic main pancreatic duct disruption treated endoscopically: a case report
- BioMed Central