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Spleen-preserving distal pancreatectomy following grade III pancreatic injury in a delayed presentation: a technical challenge
  1. Venu Bhargava Mulpuri1,
  2. Dinesh Kumar Bhuria1,
  3. Surinder Rana2 and
  4. Rajesh Gupta1
  1. 1Department of Surgical Gastoenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Professor Rajesh Gupta; rajsarakshi{at}gmail.com

Abstract

Pancreatic injuries are often overlooked in view of subtle clinical signs, and high index of suspicion is required to manage these injuries. Management strategies vary depending on the grade of injury and associated solid organ injuries and vascular injuries. Early surgery is advised in patients with duct disruption to avoid complications related to duct disruption. We present a case of 19-year-old man with delayed presentation following pancreatic trauma. During the surgery, changes of pancreatitis were noted and posterior wall of the stomach was adherent to pancreas, and inflammatory changes in vicinity of pancreas posed a significant challenge while dissecting pancreas away from the splenic vein. Spleen-preserving distal pancreatectomty (SPDP) was done. SPDP is time-consuming and technically challenging procedure especially in patients with delayed presentation. It is safe and feasible to consider spleen preservation in pancreatic trauma when patient is haemodynamically stable and expertise is available.

  • gastrointestinal surgery
  • portal vein

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Footnotes

  • Contributors VB: data collection and patient management; DKB: wrote manuscript; RG and SR: manuscript drafting and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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