Department of Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece.
Department of Radiology, University Hospital of Heraklion, Heraklion, Crete, Greece.
Am Surg. 2023 Nov;89(11):4895-4898. doi: 10.1177/00031348211038566. Epub 2021 Aug 17.
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.
孤立性胰腺损伤伴胰管横断一般采用胰腺切除术治疗，但最佳治疗方法尚无高级别证据支持。本文报告 1 例钝性腹部创伤后胰腺和胰管完全断裂的一期修复，并复习文献。1 例 33 岁男性患者因钝性腹部创伤导致孤立性胰腺损伤。剖腹探查时发现胰腺均匀断裂，仅轻微坏死和组织丢失，行端端吻合术吻合胰管和实质，并用大网膜覆盖。患者术后并发 6cm 假性囊肿和低流量胰瘘，但无需任何干预，自行缓解。文献中报道了 17 例类似的 IV 级胰腺损伤的一期修复。术后并发症主要为瘘和假性囊肿。
