Efficacy of Minimal Invasive Methods in Management of Traumatic Pancreatic Injury.
Isolated pancreatic injury is relatively uncommon due to its mostly retroperitoneal location. In this report we have discussed about the different minimal invasive management approaches in two cases of pancreatic injury.
The first case had American Association for the Surgery of Trauma Organ Injury Scale grade IV pancreatic injury
with late presentation who underwent ultrasound-guided percutaneous drainage of pseudocyst with video assisted lavage of
cavity, followed by endoscopic retrograde cholangiopancreatography guided pancreatic duct stenting. Second case had
AAST-OIS grade II pancreatic injury which was managed with serial percutaneous drainage.
Management of pancreatic injury is complex. Evolving trend of minimal invasive techniques of management for selected patients
with higher grade pancreatic injury is associated with better outcomes.
Pancreatic injury usually presents with constitutional other visceral injuries and isolated traumatic pancreatic injury is relatively uncommon due to its mostly retroperitoneal location. However,
pancreatic injury has been reported to be present in 0.2-12% of
abdominal trauma cases.
Approximately two thirds of pancreatic
injuries are due to penetrating abdominal trauma and the remaining one thirds is due to blunt trauma. Traumatic pancreatic injury
usually occurs in the neck and body region due to presence of vertebrae posteriorly and it ranges from mild contusion/hematoma to
severe crushing injury with ductal disruption.
Since pancreatic enzymes are alkaline and autolytic in nature, it causes devastating local and systemic complications if expected management is delayed.
Pancreatic injury of any grade requires treatment, ranging from
conservative management and monitoring to pancreatectomy or
pancreaticoduodenectomy.
Pancreas Open J. 2022; 5(1): 1-4. doi: 10.17140/POJ-5-112
