Citation

Bhatta OP, Bhetwal P, Gyawali P, Yadav K, Devkota S, Koirala DP. Int. J. Surg. Case Rep. 2024; 115: e109280.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.ijscr.2024.109280

PMID

38290356

Abstract

INTRODUCTION AND IMPORTANCE: Isolated pancreatic injury following blunt abdominal trauma is rare, and the absence of definite clinical signs and symptoms may delay diagnosis and management.

CASE PRESENTATION: We present the case of a seven-year-old girl with a history of progressive, periumbilical abdominal pain and multiple episodes of non-bilious, non-blood mixed vomiting following a road traffic accident. Computed tomography (CT) imaging revealed an isolated grade three pancreatic injury managed conservatively.

CLINICAL DISCUSSION: The patient usually presents with epigastric tenderness with or without a rise in pancreatic enzyme levels. CT grading of injury correlates with and guides the management approach, and CT abdomen with contrast is the preferred investigation for diagnosis. Management depends on the grade of injury, the hemodynamic status of the children, and the co-existence of other injuries.

CONCLUSION: Isolated pancreatic injury, although rare, can go undiagnosed due to a lack of suspicion from the treating surgeon and may have dire consequences. Conservative management can be a suitable strategy for children with stable hemodynamic status.

Language: en

Keywords

Abdominal injuries; Blunt abdominal trauma; Isolated pancreatic injury