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Blunt pancreatic duct injury in children
Hirotaka Yamamoto1, Takanori Ochi1,2, Eiji Miyazaki1
1Department of Surgery Seirei Hamamatsu General Hospital 2-12-12 Sumiyoshi Naka-ku Hamamatsu Shizuoka 430-8558 Japan.
Acute Medicine & Surgery
|November 11, 2017
Summary
A pediatric blunt pancreatic neck injury with duct transection was treated using a nasopancreatic drain as a guide for surgical repair. This technique facilitated identification and management of the disrupted pancreatic duct, leading to successful patient recovery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Blunt pancreatic neck injuries in children can result in complete main pancreatic duct transection.
- Management of such injuries presents challenges due to the complexity of ductal anatomy and potential for leakage.
Observation:
- A 10-year-old boy experienced a blunt pancreatic neck injury causing complete main pancreatic duct transection.
- Endoscopic catheterization across the rupture site was not feasible.
Findings:
- An endoscopic nasopancreatic drain was inserted through the proximal duct into the retroperitoneum.
- The drain served as a crucial guide during emergency laparotomy for identifying disrupted pancreatic ducts.
- Surgical intervention involved removing damaged tissue, ligating the proximal duct, and performing a Roux-en-Y distal pancreaticojejunostomy.
Implications:
- Endoscopic nasopancreatic drainage can be a valuable adjunct in managing pediatric pancreatic duct injuries when direct catheterization fails.
- This approach aids in precise surgical localization and repair of transected pancreatic ducts.
- Successful surgical management led to the patient's discharge 49 days post-operation.
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