Combination therapy with early nasopancreatic drainage and minimum surgery for blunt high-grade pancreatic trauma.

Abstract

CASE:

A 22-year-old man suffered blunt, high-grade, pancreatic trauma; however, duct-related complications were avoided by combining early nasopancreatic drainage with minimal surgery. Endoscopic retrograde pancreatography confirmed rupture of the main pancreatic duct and massive retroperitoneal extravasation. A nasopancreatic catheter was placed across the rupture site, laparotomy was carried out, and a grade IV pancreatic head laceration was sutured. Because the nasopancreatic catheter shifted out intraoperatively, another was inserted and left in place for 12 days.

OUTCOME:

The patient recovered well without any duct-related complications such as pseudocyst or external pancreatic fistula.

CONCLUSION:

A combination of early therapeutic endoscopic retrograde pancreatography and surgical repair may be useful for treating high-grade pancreatic trauma when pancreatic resection is unnecessary.

• Authors: Makoto Takaoka, Masayoshi Ono, Chika Kunishige, Yoshiki Tohma
• Journal: Acute medicine & surgery (Acute Med Surg) Vol. 1 Issue 4 Pg. 238-241 (Oct 2014) ISSN: 2052-8817 [Electronic] United States
• PMID: 29930855 (Publication Type: Case Reports)