Ono Kosuke, Abe Tomoyuki, Amano Hironobu, Yonehara Shuji, Kobayashi Tsuyoshi, Nakahara Masahiro, Ohdan Hideki, Noriyuki Toshio
Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
Department of Surgery Endoscopic Surgery, Onomichi General Hospital, Hirahara 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.
Surg Case Rep. 2020 Mar 18;6(1):54. doi: 10.1186/s40792-020-00817-w.
Traumatic pancreatic injury with a main pancreatic duct injury has a high incidence of mortality and requires a prompt and appropriate treatment. However, the best approach, and treatment options, which may be limited, remains controversial especially for the elderly patients. Herein, we present a case of traumatic pancreatic injury in an elderly patient for whom pancreatoduodenectomy was safe and effective.
An 87-year-old man was diagnosed with a traumatic pancreatic injury with a main pancreatic duct injury. In addition, the horizontal segment of the duodenum was largely eradicated. There were no comorbidities, and his vital signs were stable. A pancreatoduodenectomy was performed. The postoperative course was uneventful, and he was discharged. Pathological examination revealed a primary follicular lymphoma of the duodenum.
This case demonstrated that pancreatoduodenectomy could be performed safely for a severe pancreatic injury in an elderly patient. However, special attention should be paid to select the optimal surgical procedure. Further, this was a rare case, as initially a primary follicular lymphoma of the duodenum was suspected as a duodenal injury coexisting with a traumatic pancreatic injury because of the increased duodenal thickness.
伴有主胰管损伤的创伤性胰腺损伤死亡率高，需要及时且恰当的治疗。然而，最佳治疗方法以及可能有限的治疗选择仍存在争议，尤其是对于老年患者。在此，我们报告一例老年创伤性胰腺损伤患者，对其实施胰十二指肠切除术安全有效。
一名87岁男性被诊断为伴有主胰管损伤的创伤性胰腺损伤。此外，十二指肠水平段大部分被破坏。患者无合并症，生命体征稳定。实施了胰十二指肠切除术。术后过程顺利，患者出院。病理检查显示为十二指肠原发性滤泡性淋巴瘤。
该病例表明，对于老年患者的严重胰腺损伤，可安全地实施胰十二指肠切除术。然而，应特别注意选择最佳手术方式。此外，这是一例罕见病例，最初因十二指肠增厚，怀疑十二指肠原发性滤泡性淋巴瘤与创伤性胰腺损伤并存。
