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CASE REPORT
Non-operative management of a grade IV pancreatic injury
  1. Bharati Hiremath,
  2. Nishchit Hegde
  1. Department of General Surgery, M S Ramaiah Medical College and Hospital, Bangalore, Karnataka, India
  1. Correspondence to Dr Bharati Hiremath, drbharati_2000{at}yahoo.com

Summary

Isolated pancreatic transection with ductal disruption in blunt abdominal trauma is extremely rare. We report the case of a 14-year-old boy who suffered pancreatic transection at the junction of body and head of the pancreas; yet remarkably recovered after initial conservative management. He was periodically examined clinically and underwent regular abdominal ultrasonography. Nearly 6 months later, endoscopic retrograde cholangiopancreatography with pancreatic duct stenting, pancreatic sphincterotomy and cystogastrostomy for the pseudocyst diagnosed during the follow-up period was performed. Acute surgical management of pancreatic transection is fraught with high mortality and morbidity. Through this effort, we highlight the successful role of non-operative management of a haemodynamically stable patient with grade IV pancreatic injury, thereby avoiding radical surgery in the acute stage and preserving exocrine and endocrine function.

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