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Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
Post-traumatic duodenopancreatectomy in a child
F T Salman1, A Emre, L Abbasoğlu
1Department of Pediatric Surgery and General Surgery, I.U. Istanbul Medical School, Istanbul, Turkey.
Insights
A 5-year-old boy sustained severe abdominal injuries, including duodenal and pancreatic damage, after a car accident. Surgical repair and partial liver resection were required, with the patient recovering well.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Abdominal Trauma
Background:
- Motor vehicle accidents are a leading cause of pediatric injury.
- Seatbelt and airbag use are crucial for preventing severe abdominal trauma in children.
- Specific injury patterns can arise from unique accident dynamics.
Observation:
- A 5-year-old boy presented with severe abdominal pain post-car accident.
- The patient was positioned on the driver's lap, leading to abdominal compression between the driver and steering wheel.
- Initial assessment revealed significant duodenal and pancreatic injuries.
Findings:
- Intraoperative findings included a transected pancreas and extensive duodenal injury.
- A Whipple-type reconstruction was performed for the pancreatic and duodenal damage.
- Postoperative complications included extensive liver necrosis, necessitating a partial liver resection.
Implications:
- This case highlights the potential for severe intra-abdominal injuries in pediatric passengers, even in non-traditional seating positions.
- Complex surgical reconstructions like the Whipple procedure may be necessary for pediatric pancreatic and duodenal trauma.
- Prompt diagnosis and management of complications such as liver necrosis are critical for favorable outcomes in pediatric trauma patients.
Abstract:
We describe a 5-year-old boy who complained of severe abdominal pain after a car accident. He was sitting on the lap of the driver and his abdomen was pressed closely between the pregnant driver and the steering wheel. At operation, associated injuries to the duodenum and pancreas were detected which could not be repaired. The transected pancreas and extensive duodenal injury underwent a Whipple-type reconstruction. On postoperative day six, the patient was re-operated due to extensive liver necrosis which was detected on abdominal computerized tomography and a partial liver resection was performed. He was discharged on day 16 after the second operation and has done well so far.
