Delayed presentation of isolated complete pancreatic transection as a result of sport-related blunt trauma to the abdomen

• Published in: Case reports in gastroenterology Vol. 2; no. 1; pp. 22 - 26
• Main Authors: Healey, Andrew J, Dimarakis, Iannis, Pai, Madhava, Jiao, Long R
• Format: Report
• Language: English
• Published: 29.01.2008
• ISSN: 1662-0631; 1662-0631
• DOI: 10.1159/000112919

INTRODUCTIONBlunt abdominal trauma is a rare but well-recognized cause of pancreatic transection. A delayed presentation of pancreatic fracture following sport-related blunt trauma with the coexisting diagnostic pitfalls is presented. CASE REPORTA 17-year-old rugby player was referred to our specialist unit after having been diagnosed with traumatic pancreatic transection, having presented 24 h after a sporting injury. Despite haemodynamic stability, at laparotomy he was found to have a diffuse mesenteric hematoma involving the large and small bowel mesentery, extending down to the sigmoid colon from the splenic flexure, and a large retroperitoneal hematoma arising from the pancreas. The pancreas was completely severed with the superior border of the distal segment remaining attached to the splenic vein that was intact. A distal pancreatectomy with spleen preservation and evacuation of the retroperitoneal hematoma was performed. DISCUSSION/CONCLUSIONBlunt pancreatic trauma is a serious condition. Diagnosis and treatment may often be delayed, which in turn may drastically increase morbidity and mortality. Diagnostic difficulties apply to both paraclinical and radiological diagnostic methods. A high index of suspicion should be maintained in such cases, with a multi-modality diagnostic approach and prompt surgical intervention as required.