Very Unusual Presentation of Pancreatic Cancer Revealed by Traumatic Spleen Injury

Abstract

Accidental diagnosis of pancreatic ductal adenocarcinoma (PDAC) follow by trauma is very rare. Splenic infarction is unusual presentation of PDAC, and splenic rupture associated with PDAC has been reported in few cases so far. We present a patient with PDAC revealed by splenic laceration after blunt abdominal trauma. The 64-year-old patient visited emergency center with left flank pain derived from slipping down on the floor. The patient was diagnosed with splenic rupture, and was intended to perform urgent splenectomy. During operation, distal pancreas was resected with spleen due to possible severe chronic pancreatitis. However, he was diagnosed as having pancreas tail cancer with remnant cancer on the resected margin. We performed radiacal antegrade modular pancreatectomy (RAMPS) seven days after initial operation. We present a case of pancreatic tail adenocarcinoma revealed by blunt abdominal trauma which we recognized accidentally after trauma. Detail evaluation were performed on this patient according to history, previous imaging studies which lead to possible early diagnosis.