2016 Volume 36 Issue 6 Pages 1093-1097
Blunt isolated pancreatic injury is relatively rare. We report our use of the Letton-Wilson procedure for isolated pancreatic injury in two cases. Case 1: A 17-year-old man sustained blunt injury in the epigastric region while playing basketball. The patient presented on the day after the injury with worsening abdominal pain. Abdominal CT showed a low-density area in the pancreatic body. The findings of ERP led to the diagnosis of Type Ⅲ pancreatic injury, and emergency surgery was performed. At surgery, complete rupture of the pancreatic parenchyma ventral to the portal vein was observed. We performed the Letton-Wilson procedure to preserve the pancreas, because the patient was young and otherwise healthy. Case 2: A 22-year-old man sustained blunt abdominal injury when he collided with another player during a baseball game. The patient was diagnosed as having sustained Type Ⅲb pancreatic injury by abdominal CT and ERP, and emergency surgery was performed. This patient was also found, like Case 1, to have complete rupture of the pancreatic parenchyma. We reconstructed the pancreas by the Letton-Wilson procedure. Both patients were discharged after the wounds healed, without any serious complications. It is necessary to choose the appropriate operative procedure in each individual case of pancreatic injury. When a patient is young and the pancreas can be expected to be preserved, the Letton-Wilson procedure may be considered as the appropriate operative procedure.
