Closed traumatism of the distal pancreas (A case series of 6 patients).

Autor:	Kaitouni BI; Digestive Surgical Department, Centre Hospitalier Ibn Sina, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco. Electronic address: boubker.kaitouni@um5r.ac.ma., Achour Y; Digestive Surgical Department, Centre Hospitalier Ibn Sina, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Ouzzaouit H; Digestive Surgical Department, Centre Hospitalier Ibn Sina, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., El Aoufir O; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco; Central Radiology Department, Centre Hospitalier Ibn Sina, Rabat, Morocco., El Absi M; Digestive Surgical Department, Centre Hospitalier Ibn Sina, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco., Sekkat H; Digestive Surgical Department, Centre Hospitalier Ibn Sina, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2024 Nov; Vol. 124, pp. 110415. Date of Electronic Publication: 2024 Oct 09.
DOI:	10.1016/j.ijscr.2024.110415
Abstrakt:	Introduction and Importance: The aim of this retrospective study was to present six cases of trauma to the distal pancreas, highlighting the challenges associated with their diagnosis and management, while underlining their seriousness and the various complications potentially encountered. Our case series highlights individual patient outcomes, demonstrating the diversity of clinical presentations and the importance of customized treatment strategies. Case Series: Between January 2015 and December 2020, six cases of distal pancreas trauma were identified. In two cases, the diagnosis was made based on emergency abdominal CT scans, while in the other four patients, the diagnosis was made directly intraoperatively, mainly because of the severity of the associated lesions, which necessitated laparotomy for exploration. Clinical Discussion: Out of 115 cases of closed abdominal trauma, injury to the distal pancreas was identified in 6 patients, (5.2 %), with a mean age of 21 years. Despite the use of abdominal CT scans for all patients, pancreatic trauma was directly diagnosed intraoperatively in 4 cases (67 %). All patients presented with concomitant abdominal injuries (100 %), and 3 patients (50 %) exhibited multiple severe injuries. Additionally, a significant elevation in pancreatic serum markers was observed in 3 patients (50 %). The pancreatic injuries predominantly involved the tail of the pancreas (67 %), while the body was affected in one patient, and the isthmus was completely transected in another. Three of our patients developed a pancreatic fistula (50 %) and two patients (33 %) passed away; the first had severe associated lesions, and the second, despite undergoing several iterative laparotomies, succumbed to postoperative complications following a left pancreatectomy. Conclusion: Closed traumatism of the distal pancreas, although rare, is a significant problem. It is often diagnosed during emergency laparotomy but can sometimes be found on preoperative CT scans. When the patient's condition permits, it is highly advisable to undergo a left pancreatectomy. Simple external drainage is reserved for certain specific situations. Competing Interests: Conflict of interest statement The authors have no conflicts of interest and source of funding. The subject of study had no commercial interest, no financial or material support. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu