Delayed prognosis and therapy of excessive grade blunt pancreatic trauma. Case report and overview of literature.
Ann Ital Chir. 2017;88:539-545
Authors: Torba M, Gjata A, Rulli F, Kajo I, Ceka S, Asqeri T
INTRODUCTION: Regardless of technological development, excessive grade pancreatic accidents following blunt stomach trauma continues to stay a illness that’s related to excessive morbidity and mortality charges, notably in instances of delayed prognosis. The purpose of this paper was the presentation of delayed prognosis and therapy peculiarities of excessive grade pancreatic trauma and a overview of literature.
CASE REPORT: A 55-years outdated man, concerned in motorcar crashes, was referred to our degree I trauma heart. Hemodynamically steady. Stomach bodily examination, laboratory and targeted stomach sonography for trauma have been regular. First whole physique multidetector CT scan, carried out solely after 24 hours, confirmed virtually full left pneumothorax, left third to fifth rib fractures and subcutaneous emphysema. Left chest tube was utilized. On the eighth post-traumatic day, the overall situation of the affected person began to deteriorate. The affected person confirmed stomach ache, fever, nausea, vomiting, and bilateral flank ecchymosis. Solely the third CT scan carried out, on twelfth day, after the peritoneal indicators, modifications in blood and biochemical parameters seem, we revealed linear laceration and hypo-attenuation space of the neck and part of distal physique pancreas. In laparotomy fats necrosis, big retroperitoneal abscess, necrosis of the neck and distal physique of the pancreas, was discovered. Distal pancreatectomy with splenectomy was carried out. Postoperative course with in depth wound an infection and necrotic leakage from peripancreatic drain was sophisticated. The affected person was discharged two months after his operation with none occasions.
CONCLUSION: On time prognosis of pancreatic trauma, particularly in polytrauma sufferers, continues to stay a problem for trauma surgeons. Foremost pancreatic duct damage is a crucial prognostic issue and the main one figuring out therapeutic approaches. Ample surgical approaches lower morbidity and mortality in pancreatic trauma.
KEY WORDS: Delayed prognosis, Distal pancreatectomy, Pancreatic blunt trauma.
PMID: 29339584 [PubMed – in process]