Cargando…
Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery
INTRODUCTION AND IMPORTANCE: Isolated pancreatic injury from blunt force trauma is an extremely rare entity accounting for less than 1 % of trauma presentations. This case highlights the diagnostic difficulties of identifying a ductal injury and presents a rare instance of an isolated pancreatic tra...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178486/ http://dx.doi.org/10.1016/j.ijscr.2022.107276 |
_version_ | 1784723072492765184 |
---|---|
author | Jin, Harry Chuang, Tzu-yi Rasheed, Haroon |
author_facet | Jin, Harry Chuang, Tzu-yi Rasheed, Haroon |
author_sort | Jin, Harry |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Isolated pancreatic injury from blunt force trauma is an extremely rare entity accounting for less than 1 % of trauma presentations. This case highlights the diagnostic difficulties of identifying a ductal injury and presents a rare instance of an isolated pancreatic transection from a relatively low-impact blunt abdominal trauma. CASE PRESENTATION: A 30 year old lady presented to the emergency department 24 h following a low impact abdominal trauma. CT scan showed a complete pancreatic transection with significant peripancreatic free fluid. MRCP showed the main pancreatic duct to be in alignment on either side of the transection plane, however given the significant surrounding free fluid she was taken to the operating theatre for exploration and resective surgery. Intraoperative findings were that of a complete pancreatic transection involving the main pancreatic duct. DISCUSSION: Current management guidelines focus on the correct evaluation of main pancreatic duct integrity. Timely intervention is essential for improving mortality and morbidity outcomes. Reported sensitivity and specificity for imaging modalities vary between studies, likely reflecting inherent challenges in accurately identifying pancreatic duct injuries. Multi-modal assessment is recommended to reach a timely diagnosis and hence, institute the appropriate therapy. CONCLUSION: Low-energy trauma can result in isolated injuries of the pancreas. Multi-modal imaging should be encouraged for evaluation of main pancreatic duct integrity. This will facilitate timely decision making regarding the need for definitive surgery. |
format | Online Article Text |
id | pubmed-9178486 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-91784862022-06-10 Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery Jin, Harry Chuang, Tzu-yi Rasheed, Haroon Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Isolated pancreatic injury from blunt force trauma is an extremely rare entity accounting for less than 1 % of trauma presentations. This case highlights the diagnostic difficulties of identifying a ductal injury and presents a rare instance of an isolated pancreatic transection from a relatively low-impact blunt abdominal trauma. CASE PRESENTATION: A 30 year old lady presented to the emergency department 24 h following a low impact abdominal trauma. CT scan showed a complete pancreatic transection with significant peripancreatic free fluid. MRCP showed the main pancreatic duct to be in alignment on either side of the transection plane, however given the significant surrounding free fluid she was taken to the operating theatre for exploration and resective surgery. Intraoperative findings were that of a complete pancreatic transection involving the main pancreatic duct. DISCUSSION: Current management guidelines focus on the correct evaluation of main pancreatic duct integrity. Timely intervention is essential for improving mortality and morbidity outcomes. Reported sensitivity and specificity for imaging modalities vary between studies, likely reflecting inherent challenges in accurately identifying pancreatic duct injuries. Multi-modal assessment is recommended to reach a timely diagnosis and hence, institute the appropriate therapy. CONCLUSION: Low-energy trauma can result in isolated injuries of the pancreas. Multi-modal imaging should be encouraged for evaluation of main pancreatic duct integrity. This will facilitate timely decision making regarding the need for definitive surgery. Elsevier 2022-06-06 /pmc/articles/PMC9178486/ http://dx.doi.org/10.1016/j.ijscr.2022.107276 Text en Crown Copyright © 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://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 Jin, Harry Chuang, Tzu-yi Rasheed, Haroon Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
title | Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
title_full | Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
title_fullStr | Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
title_full_unstemmed | Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
title_short | Case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
title_sort | case report of an isolated pancreatic transection from low impact blunt abdominal trauma necessitating resective surgery |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178486/ http://dx.doi.org/10.1016/j.ijscr.2022.107276 |
work_keys_str_mv | AT jinharry casereportofanisolatedpancreatictransectionfromlowimpactbluntabdominaltraumanecessitatingresectivesurgery AT chuangtzuyi casereportofanisolatedpancreatictransectionfromlowimpactbluntabdominaltraumanecessitatingresectivesurgery AT rasheedharoon casereportofanisolatedpancreatictransectionfromlowimpactbluntabdominaltraumanecessitatingresectivesurgery |