Trauma Whipple at a community level 1 trauma center: a case report

The Whipple operation is oftentimes considered one of the most challenging and complex abdominal operations, usually reserved for duodenal and hepatopancreatobiliary malignancies. In cases of duodenal and/or pancreatic trauma with disruption of the biliary systems, a Whipple reconstruction can be performed. Such operative traumas are rare and carry with them a high level of morbidity and mortality. This case report presents a challenging 46-day clinical course of a 22-year-old African American female, who suffered multiple gunshot wounds, resulting in severe abdominal injuries. These injuries included a grade 3 duodenal injury, grade 4 pancreatic injury, and a grade 4 renal injury. The patient underwent a staged Whipple operation. Postoperative complications included pancreaticojejunostomy leak, feeding tube leak, and mesenteric bleeding, all of which required surgical and interventional radiology management. After a 46-day hospitalization, the patient was discharged to a rehab facility, achieving an impressive recovery 2 years post-surgery.