Pancreatic transection from blunt trauma associated with vascular and biliary lesions: A case report

Abstract

M a j o r i n j u r i e s o f t h e p a n c re a s m ay re s u l t i n considerable morbidity and mortality when associated with vascular and visceral injuries. In such cases, a right diagnosis and a prompt surgical intervention are necessary to give a chance to the patient. We herein describe a case of blunt abdominal trauma in a 29-yearold man whose pancreatic rupture was associated with hepatic artery, splenic vein and extrahepatic bile duct damage. Immediate surgery was performed after computer tomography (CT), the haemorrhagic lesions dictate the emergency transfer to the operating room. Spleno-pancreatic resection was done with reconstruction of the hepatic artery, ligation of the splenic vein and a Roux-en-Y bilio-jejunal diversion. The early post-operative course was complicated by stenosis of the arterial reconstruction, which was treated by endovascular angioplasty followed by percutaneous drainage of symptomatic pseudocyst, rest and antibiotics. Finally, the patient was discharged and was alive without clinical problems at the time when we wrote this case report. The present case underlines the clinical relevance of vascular and visceral injuries associated with pancreatic trauma and the problems arising in the diagnostic evaluation and the surgical strategy of complex multiple visceral and vascular lesions in blunt abdominal trauma.

Traumatic Transection of Pancreas at the Neck: Feasibility of Parenchymal Preserving Strategy

“…These patients may have associated injury to superior mesenteric portal vein axis. Patients affected by associated vascular injuries are rarely described [5]. Bradley et al [19] reported this association in only 3 of 101 cases.…”

“…Increased morbidity and mortality result from associated vascular injuries and main pancreatic duct disruption [4, 5]. …”

Post-Traumatic Necrohemorragic Pancreatitis Caused by an Air Gun

“…The hepatic lesion being the visceral lesion most commonly associated with pancreatic lesions, 19.3%, followed by the stomach, 16%, the spleen, 11%, and the colon 7.9%. Vascular lesions occupy third place among lesions accompanying pancreatic trauma: 5.5% venous (Inferior vena cava, portal vein and superior mesenteric vein) and 4.5% arterial (aorta and superior mesenteric) [1][2][3].…”