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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...

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Autores principales: Jin, Harry, Chuang, Tzu-yi, Rasheed, Haroon
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
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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.
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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
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