Emergent endoscopic retrograde cholangiopancreatography. A highly specific test for acute pancreatic trauma

Emergent endoscopic retrograde cholangiopancreatography (ERCP) was assessed as the definitive diagnostic test for acute pancreatic injury in a 23-year-old male automobile driver who sustained blunt abdominal trauma. Despite the patient's quiet, tender abdomen, rising serum amylase level, and an abdominal computed tomographic scan demonstrating probable pancreatic transection, a nonoperative approach was successful when an emergency ERCP demonstrated normal ductal anatomy. This approach is advocated when the presence of a possible pancreatic injury is the only reason for a planned exploratory laparotomy.