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Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report

Pancreatic trauma involving ductal injury is rare but is associated with high morbidity and mortality. The benefit of endoscopic retrograde pancreatography and stent placement is unclear because there are only a few case reports on endoscopically treated pancreatic duct transection at the pancreatic...

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Autores principales: Shimizu, Dai, Yamano, Toshihisa, Kudo, Yasutaka, Kuroda, Masatoshi, Takagi, Shoji, Ikeda, Eiji, Kenmotsu, Masaichi, Tsuji, Hisashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264759/
https://www.ncbi.nlm.nih.gov/pubmed/32509956
http://dx.doi.org/10.1016/j.tcr.2020.100319
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author Shimizu, Dai
Yamano, Toshihisa
Kudo, Yasutaka
Kuroda, Masatoshi
Takagi, Shoji
Ikeda, Eiji
Kenmotsu, Masaichi
Tsuji, Hisashi
author_facet Shimizu, Dai
Yamano, Toshihisa
Kudo, Yasutaka
Kuroda, Masatoshi
Takagi, Shoji
Ikeda, Eiji
Kenmotsu, Masaichi
Tsuji, Hisashi
author_sort Shimizu, Dai
collection PubMed
description Pancreatic trauma involving ductal injury is rare but is associated with high morbidity and mortality. The benefit of endoscopic retrograde pancreatography and stent placement is unclear because there are only a few case reports on endoscopically treated pancreatic duct transection at the pancreatic head. We report a rare case of grade IV pancreatic trauma successfully treated with endoscopic pancreatic stent, which we believe makes significant contribution to the existing literature. A 17-year-old man with blunt pancreatic trauma was referred to our hospital and was diagnosed with grade IV pancreatic injury using endoscopic retrograde pancreatography. The patient was successfully managed with endoscopic pancreatic duct stenting. Although stent replacement was required three times and a trivial ductal stricture remained, the patient finally became stent-free without any symptoms and further adverse events. Endoscopic retrograde pancreatography is highly advantageous for early detection and evaluation of the severity of ductal injury. Subsequent stent insertion is well tolerated in hemodynamically stable patients and is especially beneficial for the treatment of pancreatic head injuries because it allows avoidance of sub-total pancreatectomy or high-risk reconstructive surgery. Nevertheless, the long-term outcomes and appropriate management of main pancreatic duct strictures due to stents remain to be determined. Accumulation of similar case experiences is essential to address these issues.
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spelling pubmed-72647592020-06-05 Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report Shimizu, Dai Yamano, Toshihisa Kudo, Yasutaka Kuroda, Masatoshi Takagi, Shoji Ikeda, Eiji Kenmotsu, Masaichi Tsuji, Hisashi Trauma Case Rep Case Report Pancreatic trauma involving ductal injury is rare but is associated with high morbidity and mortality. The benefit of endoscopic retrograde pancreatography and stent placement is unclear because there are only a few case reports on endoscopically treated pancreatic duct transection at the pancreatic head. We report a rare case of grade IV pancreatic trauma successfully treated with endoscopic pancreatic stent, which we believe makes significant contribution to the existing literature. A 17-year-old man with blunt pancreatic trauma was referred to our hospital and was diagnosed with grade IV pancreatic injury using endoscopic retrograde pancreatography. The patient was successfully managed with endoscopic pancreatic duct stenting. Although stent replacement was required three times and a trivial ductal stricture remained, the patient finally became stent-free without any symptoms and further adverse events. Endoscopic retrograde pancreatography is highly advantageous for early detection and evaluation of the severity of ductal injury. Subsequent stent insertion is well tolerated in hemodynamically stable patients and is especially beneficial for the treatment of pancreatic head injuries because it allows avoidance of sub-total pancreatectomy or high-risk reconstructive surgery. Nevertheless, the long-term outcomes and appropriate management of main pancreatic duct strictures due to stents remain to be determined. Accumulation of similar case experiences is essential to address these issues. Elsevier 2020-05-30 /pmc/articles/PMC7264759/ /pubmed/32509956 http://dx.doi.org/10.1016/j.tcr.2020.100319 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Shimizu, Dai
Yamano, Toshihisa
Kudo, Yasutaka
Kuroda, Masatoshi
Takagi, Shoji
Ikeda, Eiji
Kenmotsu, Masaichi
Tsuji, Hisashi
Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
title Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
title_full Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
title_fullStr Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
title_full_unstemmed Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
title_short Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
title_sort diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade iv blunt pancreatic trauma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264759/
https://www.ncbi.nlm.nih.gov/pubmed/32509956
http://dx.doi.org/10.1016/j.tcr.2020.100319
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