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Related Experiment Videos

Post-traumatic pancreatic sequestrum: recognition and treatment.

K A Kudsk, D Temizer, E C Ellison

    The Journal of Trauma
    |April 1, 1986
    PubMed
    Summary

    Blunt pancreatic trauma can be subtle. Late epigastric pain may indicate pancreatic sequestrum, highlighting the need for early surgical exploration and ERCP.

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    Area of Science:

    • Trauma surgery
    • Gastroenterology
    • Surgical pathology

    Background:

    • Midline pancreatic injuries from blunt trauma are often subtle and may not present with immediate symptoms.
    • While nonoperative management is common, it can lead to delayed complications.
    • Chronic symptoms, such as epigastric pain, can manifest months to years post-injury.

    Purpose of the Study:

    • To investigate the role of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing late-presenting complications of blunt pancreatic trauma.
    • To emphasize the importance of thorough surgical evaluation for pancreatic injuries.
    • To highlight the potential for pancreatic sequestrum formation.

    Main Methods:

    • Case series review of four patients with late-onset epigastric pain after blunt abdominal trauma.

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  • Diagnostic evaluation including imaging and ERCP.
  • Surgical intervention and pathological examination.

    • Main Results:

    • All four patients developed epigastric pain 2 months to 2 years post-trauma.
    • ERCP revealed pancreatic sequestrum in these patients.
    • Surgical exploration confirmed the diagnosis and guided management.

    Conclusions:

    • Pancreatic sequestrum is a potential cause of chronic epigastric pain following blunt pancreatic injury.
    • Early and complete surgical exploration of pancreatic injuries is crucial.
    • ERCP is valuable in diagnosing pancreatic sequestrum in patients with late-onset symptoms.