Citation

Healey AJ, Dimarikis I, Pai M, Jiao LR. Case Rep. Gastroenterol. 2008; 2(1): 22-26.

Affiliation

HPB Surgery, Division of Surgery, Oncology, Reproductive Biology and Anesthetics, Imperial College of Science, Technology and Medicine, Hammersmith Hospital Campus, London, UK.

Copyright

(Copyright © 2008, Karger Publishers)

DOI

10.1159/000112919

PMID

21490833

PMCID

PMC3075161

Abstract

INTRODUCTION: Blunt abdominal trauma is a rare but well-recognized cause of pancreatic transection. A delayed presentation of pancreatic fracture following sport-related blunt trauma with the coexisting diagnostic pitfalls is presented. CASE REPORT: A 17-year-old rugby player was referred to our specialist unit after having been diagnosed with traumatic pancreatic transection, having presented 24 h after a sporting injury. Despite haemodynamic stability, at laparotomy he was found to have a diffuse mesenteric hematoma involving the large and small bowel mesentery, extending down to the sigmoid colon from the splenic flexure, and a large retroperitoneal hematoma arising from the pancreas. The pancreas was completely severed with the superior border of the distal segment remaining attached to the splenic vein that was intact. A distal pancreatectomy with spleen preservation and evacuation of the retroperitoneal hematoma was performed.

DISCUSSION/CONCLUSION: Blunt pancreatic trauma is a serious condition. Diagnosis and treatment may often be delayed, which in turn may drastically increase morbidity and mortality. Diagnostic difficulties apply to both paraclinical and radiological diagnostic methods. A high index of suspicion should be maintained in such cases, with a multi-modality diagnostic approach and prompt surgical intervention as required.

Language: en