Diagnostic and therapeutic role of endoscopic retrograde pancreatography and stent placement for grade IV blunt pancreatic trauma: A case report
| Autor: | Masaichi Kenmotsu, Hisashi Tsuji, Shoji Takagi, Masatoshi Kuroda, Toshihisa Yamano, Eiji Ikeda, Yasutaka Kudo, Dai Shimizu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Reconstructive surgery medicine.medical_treatment Blunt abdominal trauma lcsh:Surgery Case Report Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Blunt medicine Non-operative Orthopedics and Sports Medicine Adverse effect Endoscopic retrograde pancreatography Pancreatic duct 030222 orthopedics business.industry Pancreatic stent Pancreatic injury 030208 emergency & critical care medicine lcsh:RD1-811 medicine.disease Surgery medicine.anatomical_structure Pancreatic trauma Pancreatectomy Emergency Medicine business |
| Zdroj: | Trauma Case Reports Trauma Case Reports, Vol 28, Iss, Pp 100319-(2020) |
| ISSN: | 2352-6440 |
| Popis: | Pancreatic trauma involving ductal injury is rare but is associated with high morbidity and mortality. The benefit of endoscopic retrograde pancreatography and stent placement is unclear because there are only a few case reports on endoscopically treated pancreatic duct transection at the pancreatic head. We report a rare case of grade IV pancreatic trauma successfully treated with endoscopic pancreatic stent, which we believe makes significant contribution to the existing literature. A 17-year-old man with blunt pancreatic trauma was referred to our hospital and was diagnosed with grade IV pancreatic injury using endoscopic retrograde pancreatography. The patient was successfully managed with endoscopic pancreatic duct stenting. Although stent replacement was required three times and a trivial ductal stricture remained, the patient finally became stent-free without any symptoms and further adverse events. Endoscopic retrograde pancreatography is highly advantageous for early detection and evaluation of the severity of ductal injury. Subsequent stent insertion is well tolerated in hemodynamically stable patients and is especially beneficial for the treatment of pancreatic head injuries because it allows avoidance of sub-total pancreatectomy or high-risk reconstructive surgery. Nevertheless, the long-term outcomes and appropriate management of main pancreatic duct strictures due to stents remain to be determined. Accumulation of similar case experiences is essential to address these issues. Highlights • We report a case of pancreatic head injury treated with endoscopic pancreatic stent. • Endoscopic retrograde pancreatography enables early detection of ductal injury. • Ductal stent is useful for pancreatic head trauma patient if hemodynamically stable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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