Abstract
Treating type IIIb pancreatic injury requires different techniques, the appropriate one being selected based on the subjects general condition. We report a case of type IIIb pancreatic injury requiring emergency Letton–Wilson surgery.
A 19–year–old man brought by ambulance and seen for upper abdominal pain from an abdominal blow during a fight was found in abdominal computed tomography (CT) upon arrival to have type II (superficial) pancreatic and hepatic injury. Eight hours after injury and follow–up admission, CT showed ascites retention in Douglas′ pouch, fluid collection around the duodenum, and irritative peritoneal signs. Emergency surgery based on a diagnosis of injury–related hepatic/pancreatic peritonitis, showed complete pancreatic rupture (type IIIb pancreatic injury) necessitating surgery using the Letton–Wilson technique. A postoperative intraperitoneal abscess was relieved by puncture drainage alone and the man was discharged.
