Conservative surgery for pancreatic neck transection

2015 ◽  
Vol 87 (6) ◽  
Author(s):  
Divya Dahiya ◽  
Surinder Singh Rana ◽  
Lileswar Kaman ◽  
Arunanshu Behera
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Conservative Surgery ◽  
Pancreatic Injury ◽  
High Morbidity ◽  
Solid Organ ◽  
Lesser Sac ◽  
Pancreatic Neck ◽  
Isolated Pancreatic Injury ◽  
Immediate Surgery

AbstractPancreas is the fourth solid organ injured in blunt abdominal trauma. Isolated pancreatic injury is present in less than 1% of patients. As it is associated with high morbidity and mortality, management is controversial.Isolated pancreatic trauma cases with pancreatic neck transection following blunt abdominal trauma were analyzed. All these patients were treated with immediate surgery involving lesser sac drainage and feeding jejunostomy only.Authors conclude that lesser sac drainage can be used as an alternative to distal pancreatectomy or pancreaticojejunostomy or pancreaticogastrostomy.

Primary Repair of Traumatic Complete Pancreatic Rupture

2021 ◽  
pp. 000313482110385
Author(s):  
Maria Venianaki ◽  
Despoina Ierodiakonou ◽  
Evangelia Chryssou ◽  
Emmanuel Chrysos ◽  
Georgios Chalkiadakis ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Primary Repair ◽  
Pancreatic Injury ◽  
Tissue Loss ◽  
Omental Patch ◽  
Pancreatic Injuries ◽  
Isolated Pancreatic Injury ◽  
High Level

Isolated pancreatic injury with transection of the pancreatic duct is generally treated with pancreatic resection, but the optimal management is not based on high-level evidence. Herein, we report a case of primary repair of complete rupture of the pancreas and pancreatic duct after a blunt abdominal trauma and a review of the literature. A 33-year-old patient had an isolated pancreatic injury after blunt abdominal trauma. At laparotomy, an even transection was found with minimal necrosis and tissue loss and an end-to-end anastomosis of the duct and the parenchyma with omental patch was performed. Patient’s postoperative course was complicated by a 6 cm pseudocyst and a low output pancreatic fistula which did not require any intervention and were self-limited. In the literature, 17 cases with primary repair of similar grade IV pancreatic injuries have been reported. Postoperative complications included mostly fistulas and pseudocysts.

Isolated pancreatic injury following blunt abdominal trauma in a child

2007 ◽  
Vol 11 (2) ◽  
pp. 96-98 ◽  
Author(s):  
Sandeep Jain ◽  
Parag Telang ◽  
M.A. Joshi ◽  
Sandhya Prabhakar
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Pancreatic Injury ◽  
Isolated Pancreatic Injury

scholarly journals Management of isolated high grade blunt pancreatic injury; case report on lesser aggressive approach

2019 ◽  
Vol 6 (5) ◽  
pp. 1789
Author(s):  
Manjit Singh ◽  
Mritunjay Sarawagi ◽  
Anjay Kumar ◽  
Uday Kumar
Keyword(s):  
Case Report ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Pancreatic Injury ◽  
High Index ◽  
High Grade ◽  
Rare Entity ◽  
Aggressive Approach ◽  
Isolated Pancreatic Injury ◽  
High Index Of Suspicion

Isolated high grade pancreatic injury is rare after blunt abdominal trauma. It is a rare entity to appreciate intra-operatively and a high index of suspicion should always be kept in mind to reach the diagnosis. We are presenting our experience of four cases with moderate to high grade isolated pancreatic injury which were managed in a lesser aggressive approach and had an uneventful outcome.

Is Hypaque Dangerous?

PEDIATRICS ◽  
1989 ◽  
Vol 83 (4) ◽  
pp. 650-650
Author(s):  
ROBERT SCHLECHTER ◽  
ABRAHAM BESSERMAN
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Ct Scanning ◽  
Ct Scans ◽  
Solid Organ ◽  
Abdominal Ct ◽  
Injured Child ◽  
Gastric Distention ◽  
Close Observation

Concerning the use of diatrizoate sodium (Hypaque) in abdominal CT scans described by Kane et al (Pediatrics 1988;82:11-15), we agree that there is certainly much to be gained from CT scanning in blunt abdominal trauma. We question the routine use of diatrizoate sodium in an injured child predisposed to gastric distention and vomiting. This is particularly dangerous when he or she is prone and restrained and close observation at the bedside is not possible. Solid organ injuries are well demonstrated without contrast, and injury to a viscus can be evaluated clinically and by routine roentgenographic procedures.

Pancreatic Injury from Blunt Abdominal Trauma in Childhood

2005 ◽  
Vol 105 (3) ◽  
pp. 283-286 ◽  
Author(s):  
V. Ruszinkó ◽  
P. Willner ◽  
A. Oláh
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Pancreatic Injury

Isolated Low-Grade Solid Organ Injuries in Children Following Blunt Abdominal Trauma

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Leah Plumblee ◽  
Regan Williams ◽  
Dennis Vane ◽  
Jingwen Zhang ◽  
Aaron Jensen ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Low Grade ◽  
Solid Organ

Operative Intervention for Complete Pancreatic Transection in Children Sustaining Blunt Abdominal Trauma: Revisiting an Organ Salvage Technique

2011 ◽  
Vol 77 (5) ◽  
pp. 612-620 ◽  
Author(s):  
Matthew J. Borkon ◽  
Stephen E. Morrow ◽  
Elizabeth A. Koehler ◽  
Yu Shyr ◽  
Melissa A. Hilmes ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Injury Severity ◽  
Demographic Data ◽  
Operative Management ◽  
Pancreatic Injury ◽  
Pancreatic Tissue ◽  
Management Algorithm ◽  
Lengths Of Stay ◽  
Pancreatic Transection

Complete pancreatic transection (CPT) in children is managed commonly with distal pancreatectomy (DP). Alternatively, Roux-en-Y distal pancreaticojejunostomy (RYPJ) may be performed to preserve pancreatic tissue. The purpose of this study was to review our experience using either procedure in the management of children sustaining CPT after blunt abdominal trauma. We retrospectively reviewed the records of all children admitted to our institution during the last 15 years who were confirmed at operation to have CPT after blunt mechanisms. Summary statistics of demographic data were performed to describe children receiving either RYPJ or DP. CPT occurred in 28 children: 15 had DP, 10 had RYPJ, and three had cystogastrostomy. RYPJ children, compared with DP, were younger (7.5 vs 12.3 years, P = 0.039) and sustained more grade IV pancreatic injuries (70% vs 14%, P = 0.01). DP patients were 5.63 times more likely to tolerate full enteral feeds ( P = 0.009). Nevertheless, when controlling for age, injury severity score, and pancreatic injury grade, procedure type did not statistically affect total and postoperative lengths of stay and postoperative complications. In the operative management algorithm of children sustaining CPT, DP may afford an earlier return to full enteral feeds. RYPJ seems otherwise equivalent to DP and preserves significant pancreatic glandular tissue and the spleen.

Intra-abdominal Free Fluid without Solid Organ Injury in Blunt Abdominal Trauma: An Indication for Laparotomy

2002 ◽  
Vol 52 (6) ◽  
pp. 1134-1140 ◽  
Author(s):  
Alexander K. T. Ng ◽  
Richard K. Simons ◽  
William C. Torreggiani ◽  
Stephen G. F. Ho ◽  
Andrew W. Kirkpatrick ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Organ Injury ◽  
Free Fluid ◽  
Solid Organ ◽  
Solid Organ Injury
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