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Complete disruption of the main pancreatic duct: a case successfully managed by percutaneous drainage
1Department of Pediatric Surgery, Fukuoka Children's Hospital, Japan.
Insights
A 7-year-old boy with blunt abdominal trauma developed a pancreatic pseudocyst. Percutaneous drainage successfully treated the injury, preserving pancreatic function long-term.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Trauma Management
Background:
- Blunt abdominal trauma can lead to severe pancreatic injuries.
- Traumatic pancreatic pseudocysts pose significant clinical challenges.
- Management often requires multidisciplinary approaches.
Observation:
- A 7-year-old boy experienced blunt abdominal trauma from a bicycle handlebar.
- This resulted in a large traumatic pancreatic pseudocyst.
- Complete disruption of the main pancreatic duct was diagnosed.
Findings:
- Percutaneous external drainage under ultrasound guidance was performed.
- The pancreatic pseudocyst resolved completely during continuous drainage.
- Catheter fistulogram and endoscopic retrograde cholangiopancreatogram confirmed ductal disruption.
Implications:
- Percutaneous drainage is an effective treatment for traumatic pancreatic pseudocysts.
- Successful management can preserve normal endocrine and exocrine pancreatic function.
- This approach offers a minimally invasive option for pediatric pancreatic trauma.
Abstract:
The authors report on a 7-year-old boy who sustained blunt abdominal trauma on a bicycle handlebar. A large traumatic pancreatic pseudocyst developed, for which percutaneous external drainage under ultrasound guidance was performed. Both the catheter fistulogram and endoscopic retrograde cholangiopancreatogram showed complete disruption of the main pancreatic duct. During continuous external drainage, the pseudocyst disappeared. The drainage flow decreased gradually and ceased. The patient is well, with normal endocrine and exocrine pancreatic functions, 2 years after discharge.