Alexandre Zanchenko Fonseca, Marcelo Augusto Fontenelle Ribeiro Jr, Orlando Contrucci, Alexandre Pompeo, Adriana Orsetti, Herico Arsie Neto, Department of General Surgery, University of Santo Amaro, São Paulo-SP, CEP 04601-060, Brazil.
World J Gastrointest Surg. 2011 Sep 27;3(9):138-41. doi: 10.4240/wjgs.v3.i9.138.
Blunt isolated pancreatic trauma is uncommon, accounting for 1%-4% of high impact abdominal injuries. In addition, its diagnosis can be difficult; physical signs may be poor and laboratory findings nonspecific, resulting in delayed treatment. Preserving the spleen during distal pancreatectomy (DP) is controversial. One of the spleen's functions regards immunity; complications following splenectomy include leukocytosis, thrombocytosis, overwhelming post splenectomy sepsis and some degree of immunodeficiency. This is why many authors favor its preservation. We describe a case of a young man with an isolated pancreatic trauma due to a blunt abdominal trauma with a delayed presentation who was treated with spleen-preserving DP and we discuss the value of this procedure with reference to the literature.
钝性孤立性胰腺外伤并不常见，占高能量腹部损伤的 1%-4%。此外，其诊断可能较为困难；体征可能不佳，实验室检查结果也不特异，导致治疗延误。在胰体尾切除术（DP）中保留脾脏存在争议。脾脏的功能之一是免疫；脾切除术后的并发症包括白细胞增多、血小板增多、脾切除术后感染性休克和一定程度的免疫缺陷。这就是为什么许多作者赞成保留脾脏。我们描述了一例因钝性腹部外伤导致孤立性胰腺外伤的年轻患者，其表现延迟，采用保留脾脏的 DP 治疗，我们结合文献讨论了该手术的价值。
