Pancreatic Body Fracture does not Necessarily Imply Loss of Ductal Integrity Following Blunt Trauma Abdomen—A Rare Image

Abstract

Pancreatic injuries can result in significant morbidity and mortality if missed or unnoticed and also pose a great challenge in terms of diagnosis and treatment. We present a case of an 11 year old boy presenting with history of blunt trauma abdomen following handle bar injury. He had signs of abdominal distension and CECT of the abdomen showed transection of the pancreas in the region of junction between the body and tail. On exploratory laparotomy there was rupture at junction of body and tail of pancreas with intact pancreatic duct and a spleen preserving distal pancreatectomy was performed. In the presence of an intact pancreatic duct conservative management should be offered however this patient underwent spleen preserving distal pancreatectomy because of pancreatitis and necrosis ensuing in the pancreatic remnant margin. Hence, complete transection does not necessarily mean loss of ductal integrity and decision to preserve or remove the distal pancreas should not be based merely on ductal integrity but probably other factors also i.e. pancreatitis and necrosis.