Early laparoscopic approach to pancreatic injury following blunt abdominal trauma

Abstract

The incidence of pancreatic injury following blunt abdominal trauma is rare. A timely accurate diagnosis of such injury is difficult and also the management remains controversial. Here, we reported the successful use of laparoscopy to diagnose, characterize and treat blunt pancreatic trauma in a 28-year-old male patient involved in a motor vehicle crash. An abdominal computed tomography scan showed peripancreatic fat stranding suggestive of pancreatic injury. With persistent clinical signs of peritonitis and laboratory investigations suggestive of pancreatitis, the patient underwent laparoscopic drainage of the lesser sac. The patient had an uneventful postoperative course. The management of patients with blunt pancreatic injuries should be tailored to individual situations. Our experience suggests that a timely laparoscopic management of traumatic pancreatic injury is safe approach in selected cases.

Figure 1:

CT abdomen showing two hepatic lacerations in addition to minimal subhepatic and left subdiaphragmatic free fluid.

Figure 2:

The intraoperative extension of the pancreatic necrosis that involves the entire gland.

Figure 3:

Chest X-ray demonstrated a large left-sided pleural effusion.