通过多阶段内镜治疗成功处理主胰管完全断裂的严重胰腺损伤：一例病例报告
Severe pancreatic injury with total disruption of main pancreatic duct successfully managed by multi-stage endoscopic therapy: a case report.
作者信息
Ito Kei, Endo Akira, Kobayashi Masanori, Otomo Yasuhiro
机构信息
Trauma and Acute Critical Care Center Tokyo Medical and Dental University Hospital of Medicine Tokyo Japan.
Department of Gastroenterology and Hepatology Tokyo Medical and Dental University Hospital of Medicine Tokyo Japan.
出版信息
Acute Med Surg. 2022 Feb 12;9(1):e735. doi: 10.1002/ams2.735. eCollection 2022 Jan-Dec.
BACKGROUND
The management of pancreatic injury is not well-established. Recently, endoscopic therapy has been reported as a treatment option for main pancreatic duct disruption.
CASE PRESENTATION
A 68-year-old man presented to our hospital and was diagnosed with severe traumatic pancreatic injury that developed 2 days prior. Endoscopic retrograde cholangiopancreatography revealed main pancreatic duct disruption. Although initial stenting to the distal main pancreatic duct was not achieved because of the widespread intermediate fluid collection, an endoscopic naso-pancreatic drainage tube was successfully inserted into the main duodenal papilla. After drainage, the endoscopic naso-pancreatic drainage tube was replaced with an endoscopic retrograde pancreatic drainage tube, and a stent was successfully placed into the distal main pancreatic duct the minor papilla.
CONCLUSION
We report a case of severe pancreatic injury managed using multi-stage endoscopic therapy that could be a possible treatment strategy for pancreatic injury with total main pancreatic duct disruption.
背景
胰腺损伤的处理方法尚未完全确立。最近，有报道称内镜治疗可作为主胰管破裂的一种治疗选择。
病例介绍
一名68岁男性因2天前发生的严重创伤性胰腺损伤入院。内镜逆行胰胆管造影显示主胰管破裂。尽管由于广泛的中间液体积聚，最初未能成功对主胰管远端进行支架置入，但成功地将一根内镜鼻胰引流管插入十二指肠乳头。引流后，将内镜鼻胰引流管更换为内镜逆行胰管引流管，并成功通过小乳头在主胰管远端置入支架。
结论
我们报告了一例采用多阶段内镜治疗的严重胰腺损伤病例，这可能是一种治疗主胰管完全破裂的胰腺损伤的可行治疗策略。
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