A Case of Type III Pancreatic Injury Due to Abdominal Blunt Trauma Caused by a Cow

Abstract

We report a case of type III pancreatic injury successfully treated with a pancreatogastrostomy. A 36-year-old woman was caught between a cow and a fence, and had a bruise on her abdomen. She was admitted to our hospital with pancreatic injury diagnosed with abdominal computed tomography (CT). CT revealed a complete transection of the pancreas and emergency surgery was performed. Laparotomy showed a complete pancreatic transection including the main pancreatic duct at the right border of the superior mesenteric vein. The oral stump of the main pancreatic duct was closed with ligations and the pancreatic stump with 3-0 silk interrupted sutures. The distal pancreas was preserved and the stump was anastomosed to the stomach to preserve pancreatic function. The patient's postoperative course was uneventful except for a transient fever at the beginning of oral intake. The blood glucose level remained normal, and exocrine pancreatic function was been preserved at one year after discharge. It is considered that a distal pancreatogastrostomy is a suitable procedure for type III pancreatic injury from the standpoint of preserving pancreatic function.