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Pancreatic fracture

jduchesne1 jduchesn at tulane.edu
Wed Aug 27 21:08:24 BST 2008

Thanks for sharing this interesting case!
Clinically fine while npo sounds like a big zebra to me with a grade III pancreatic injury....... if the anatomical ductal roadmap is intact in an ercp.......I will continue non-op management...... If ercp not available then OR with cholecystectomy and pancreatogram..... if injured I will proceed with distal panc Vs. wide drainage based on findings.
Good case
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-----Original Message-----
From: Tidewater001 <tidewater001 at aol.com>

Date: Wed, 27 Aug 2008 13:19:42 
To: <trauma-list at trauma.org>
Subject: Pancreatic fracture

Anyone out there have any thoughts on pancreatic trauma....case...13 y/o male...6' 3" 180 lbs playing around with friends & got hit with someones knee in upper abd. 36 hrs later comes to my facility with complaints of MILD and pain...ER MD gets abd/pelvis CT and this shows fx of Pancreas at head/body junction....small assoc.hematoma...no free fluid....labs all normal...clinically he is fine...MRCP poor quality...GI will NOT ERCP...repeat CT 48 hrs after admission shows improvement...diet advanced without problems...I was planning repeat CT in 6-8 weeks to see how it looks. Would anyone have done anything different...thanks

Gregory T. Squires, MD FACS
Clinical Assist. Prof. of Surgery
Medical University of SC
Director of Trauma
Trident Regional Medical Center
Charleston, SC 
trauma-list : TRAUMA.ORG
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