Blunt Pancreatic Transection With Ductal Disruption in a Stable Patient: Rethinking Surgical Necessity Through a...

Area of Science:

• Trauma Surgery
• Gastroenterology
• Diagnostic Imaging

Background:

• Blunt pancreatic trauma is rare and challenging to diagnose early due to its location and subtle symptoms.
• High-grade pancreatic injuries with ductal disruption typically necessitate surgical intervention.

Purpose of the Study:

• To present a case of successful nonoperative management for a high-grade blunt pancreatic injury with suspected ductal disruption.
• To support the conservative approach in select hemodynamically stable patients with severe pancreatic trauma.

Main Methods:

• A 20-year-old female patient with Grade III pancreatic transection after blunt abdominal trauma.
• Diagnostic imaging including MRI and contrast-enhanced CT to assess injury severity.
• Multidisciplinary team decision for nonoperative management (antibiotics, bowel rest, parenteral nutrition, monitoring).

Main Results:

• The patient remained hemodynamically stable despite delayed diagnosis.
• Complete distal pancreatic transection and splenic contusion were confirmed.
• Successful recovery without surgical intervention, complications, pseudocyst, or abscess formation.

Conclusions:

• Conservative management can be safe and effective for selected high-grade pancreatic injuries with ductal disruption.
• Early imaging, multidisciplinary coordination, and individualized treatment are crucial for optimal outcomes.
• This approach is particularly relevant in resource-limited settings.