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Pancreatic fracture

McSwain, Norman E Jr. nmcswai at tulane.edu
Wed Aug 27 21:13:22 BST 2008


Or NO drainage if you fix the duct well

Norman
 
Norman McSwain MD
Professor, Tulane School of Medicine
Trauma Director, Charity Hospital Trauma Center
norman.mcswain at tulane.edu
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of jduchesne1
Sent: Wednesday, August 27, 2008 3:08 PM
To: Trauma & Critical Care mailing list
Subject: Re: Pancreatic fracture

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
Duchesne
CharityOne
Sent via BlackBerry by AT&T

-----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 
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