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Pancreatic injury.

Ανέστης Καρακατσάνης ankarakatsanis at gmail.com
Sat Apr 2 19:31:28 BST 2016


Dear Martha and other members,

   In my mind, all these anastomoses with such a trauma burden may be a
little too risky. I do not think that the performed surgery was damage
control. Having received such a patient as you did, I would probably have a
very low threshold for operationg again and checking the duodenum primarily
and the ileotransverse anastomosis thereafter, keeping in mind however that
only drainage may be required. Please, keep us posted for the follow up and
good luck with that hypothetical patient!!!!

   Kind regards,
Anestis Karakatsanis
General surgeon, Critical Care Fellow

2016-04-02 20:45 GMT+03:00 Miki Muggia <muggia at bezeqint.net>:

> Hi,
> Do you have some CT pictures?
> M/ Muggia
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of Martha Quiodettis
> Sent: Saturday, 02 April, 2016 9:08 AM
> To: trauma-list at trauma.org
> Subject: Pancreatic injury.
>
> Need advice in a difficult case. 58 yo Female. POD# 10.   GSW to upper
> abdomen. Injuries to stomach, first portion of duodenum, pancreas, liver
> and
> right colon. (Do not know all the details of this surgery since it was
> performed in other hospital)
> E-lap, duodenum, stomach primary repair+ liver and pancreas hemostasis and
> drains + Right side hemicolectomy and ileo- colon transverse anastomosis.
> Today transferred to the hospital I work. Hemodynamically stable.
> Ventilated. Looks not so sick. All drainages with dark fluid.
> Abdominal CT made today showed a fluid collection with gas above the liver
> and in right goiter plus total transection of the body of pancreas.
> What do you do in a patient like this?
> Percutaneous drainage???  E lap +
> Distal pancreatectomy 10 days after an injury?  try ERCP and pancreatic
> stent??
>
>
> Dra. Martha Quiodettis MD. FACS
>
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