Abstract
A 25-year-old man was on a fishing boat when a net and roller for hoisting got wrapped around his abdomen. CT showed pancreatic rupture and hepatic injury at the level of the left margin of the portal vein, extravasation of contrast agent at the root of the right renal vein, and an area of poor contrast enhancement in the left kidney. Emergency surgery was performed for multiple abdominal injuries. Surgical findings showed pancreatic rupture, rupture of the stomach and jejunum, injury to the transverse and sigmoid colon, and right retroperitoneal hematoma. We performed distal pancreatectomy, hepatorrhaphy, partial gastrectomy, Roux-en-Y anastomosis, transverse/sigmoid colectomy, and colostomy. As the right retroperitoneal hematoma showed no enlargement and was deemed to be in a hemostatic state, follow-up observations were scheduled. After surgery, the patient experienced anuria, but left hydronephrosis was observed, and urination resumed with nephrostomy. Left urography showed ureteral injury. Later, the patient showed a favorable course and was discharged. At about 9 months after surgery, we closed the left nephrostomy with a left urinary tract reconstruction, then anastomosed the transverse and sigmoid colon to close the colostomy. The patient has been rehabilitated at this point in time. We report herein, with some discussion of the literature, our experience with successful treatment of multiple abdominal injuries with pancreatic injury complicated by kidney injury.
