Blunt pancreatic trauma with main pancreatic duct disruption managed successfully with total parenteral nutrition: Report of a case

Surgery Today ◽  
1995 ◽  
Vol 25 (1) ◽  
pp. 76-78 ◽  
Author(s):  
Yoshio Shirai ◽  
Kazuhiro Tsukada ◽  
Yoichi Yamadera ◽  
Tetsuya Ohtani ◽  
Terukazu Muto ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Pancreatic Trauma ◽  
Blunt Pancreatic Trauma ◽  
Pancreatic Duct Disruption ◽  
Duct Disruption

Pancreatico-enterostomy for isolated main pancreatic duct disruption

Injury ◽  
2008 ◽  
Vol 39 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Galya E. Chinnery ◽  
Sandie R. Thomson ◽  
Fernando Ghimenton ◽  
Frank Anderson
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Pancreatic Duct Disruption ◽  
Duct Disruption

The incidence of main pancreatic duct disruption in severe biliary pancreatitis

1998 ◽  
Vol 176 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Generoso Uomo ◽  
Domenico Molino ◽  
Mario Visconti ◽  
Alfonso Ragozzino ◽  
Gianpiero Manes ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Biliary Pancreatitis ◽  
Pancreatic Duct Disruption ◽  
Duct Disruption

scholarly journals Pancreatic trauma

2013 ◽  
Vol 95 (4) ◽  
pp. 241-245 ◽  
Author(s):  
R Lahiri ◽  
S Bhattacharya
Keyword(s):  
Prognostic Factor ◽  
Pancreatic Duct ◽  
Operative Management ◽  
Pancreatic Injury ◽  
Pancreatic Trauma ◽  
Important Prognostic Factor ◽  
Pancreatic Duct Disruption ◽  
Upper Abdominal ◽  
High Index Of Suspicion ◽  
Duct Disruption

Introduction Pancreatic trauma occurs in approximately 4% of all patients sustaining abdominal injuries. The pancreas has an intimate relationship with the major upper abdominal vessels, and there is significant morbidity and mortality associated with severe pancreatic injury. Immediate resuscitation and investigations are essential to delineate the nature of the injury, and to plan further management. If main pancreatic duct injuries are identified, specialised input from a tertiary hepatopancreaticobiliary (HPB) team is advised. Methods A comprehensive online literature search was performed using PubMed. Relevant articles from international journals were selected. The search terms used were: ‘pancreatic trauma’, ‘pancreatic duct injury’, ‘radiology AND pancreas injury’, ‘diagnosis of pancreatic trauma’, and ‘management AND surgery’. Articles that were not published in English were excluded. All articles used were selected on relevance to this review and read by both authors. Results Pancreatic trauma is rare and associated with injury to other upper abdominal viscera. Patients present with non-specific abdominal findings and serum amylase is of little use in diagnosis. Computed tomography is effective in diagnosing pancreatic injury but not duct disruption, which is most easily seen on endoscopic retrograde cholangiopancreaticography or operative pancreatography. If pancreatic injury is suspected, inspection of the entire pancreas and duodenum is required to ensure full evaluation at laparotomy. The operative management of pancreatic injury depends on the grade of injury found at laparotomy. The most important prognostic factor is main duct disruption and, if found, reconstructive options should be determined by an experienced HPB surgeon. Conclusions The diagnosis of pancreatic trauma requires a high index of suspicion and detailed imaging studies. Grading pancreatic injury is important to guide operative management. The most important prognostic factor is pancreatic duct disruption and in these cases, experienced HPB surgeons should be involved. Complications following pancreatic trauma are common and the majority can be managed without further surgery.

scholarly journals Complete traumatic main pancreatic duct disruption treated endoscopically: a case report

2014 ◽  
Vol 8 (1) ◽  
Author(s):  
Antonios Vezakis ◽  
Vasilios Koutoulidis ◽  
Georgios Fragulidis ◽  
Georgios Polymeneas ◽  
Andreas Polydorou
Keyword(s):  
Case Report ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Pancreatic Duct Disruption ◽  
Duct Disruption

scholarly journals Pancreatic trauma: proposal for management algorithm

2020 ◽  
Author(s):  
Daisuke Hashimoto ◽  
Tomohisa Yamamoto ◽  
So Yamaki ◽  
Kazuhito Sakuramoto ◽  
Rintaro Yui ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Mortality Rate ◽  
Pancreatic Duct ◽  
Conservative Management ◽  
Main Pancreatic Duct ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Pancreatic Trauma ◽  
Endoscopic Nasopancreatic Drainage ◽  
Nasopancreatic Drainage

IntroductionPancreatic trauma is potentially lethal despite recent improvements in surgical techniques and conservative management. However, no guidelines for the management of pancreatic trauma have been established. In this report, we propose an algorithm for the management of pancreatic trauma based on our experience of nine cases and a literature review.Case presentationThis study included nine patients with pancreatic trauma (five men and four women). The patients’ median age was 40 years (range, 17–75 years). The overall mortality rate was 22.2%, and the postoperative mortality rate was 16.7%. Superficial trauma was present in two patients. Deep trauma without injury to the main pancreatic duct was present in one patient, and this patient was treated successfully with endoscopic nasopancreatic drainage. Active bleeding was present in two patients and controlled by interventional radiology. Deep trauma with injury to the main pancreatic duct was present in six patients. Among them, one patient died after conservative treatment with endoscopic nasopancreatic drainage. The other five patients underwent surgery (pancreatic resection in four and necrosectomy in one).ConclusionThe herein-described algorithm recommends interventional radiology for active arterial bleeding, conservative management for trauma without ductal injury, and surgery for trauma with ductal injury. This algorithm may provide a basis for future establishment of guidelines.

scholarly journals Diagnosis of pancreatic duct disruption in acute pancreatitis

2021 ◽  
Vol 26 (2) ◽  
pp. 15-24
Author(s):  
T. G. Dyuzheva ◽  
A. V. Shefer ◽  
E. V. Dzhus ◽  
M. V. Tokarev ◽  
A. P. Stepanchenko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Pancreatic Duct Disruption ◽  
Duct Disruption

Novel Promising Technique for Traumatic Pancreatic Injury Management.

2020 ◽  
Author(s):  
Mohammed Hamada Takrouney ◽  
Vipul Prakash Bothara ◽  
Bhushan Jahhav ◽  
Mohamed Abdelkader Osman ◽  
Ibrahim Ali Ibrahim ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Median Time ◽  
Main Pancreatic Duct ◽  
Primary Repair ◽  
Pancreatic Injury ◽  
Pancreatic Trauma ◽  
Average Hospital ◽  
Pancreatic Injuries ◽  
The Status ◽  
Average Operative Time

Abstract Introduction: Pancreatic injuries in children are relatively uncommon. The precise location of the injury, the status of the main pancreatic duct, and the time between diagnosis and intervention are a potentially useful guide for management decisions. We report a successful endoscopic simple primary repair with the pancreatic preservation even with transected main pancreatic duct without duct stenting.Patients and Methods: Between May 2017and December 2019, 3 patients with pancreatic trauma and duct transection underwent endoscopic (laparoscopic and robotic) repair. Demographics, Operative data, Postoperative complications, and clinical outcomes were documented and analyzed.Results: Three patients with pancreatic fractures, 2 patients with grade IV, and one patient grade III injury. The median age was 11 years, the median time of hospital admission after the trauma was 72 hours. The median time of surgical intervention was 24 hours. Average operative time was160 minute and the average hospital stay was 9 days with no recorded postoperative or follow up complications till now.Conclusion: Primary simple pancreatic repair is a promising and plausible technique for the management of pancreatic trauma, especially with duct transaction it maybe instead of all other modalities of pancreatic trauma treatment. We implore all pediatric surgery centers to espouse this technique.

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