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.
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