Two Cases of Pancreatic Trauma Type IIIb ; Surgically and Non-surgically Managed

Abstract

Here, we report two cases of pancreatic trauma type IIIb.

A 22-year-old man presented with abdominal pain following a personal watercraft accident. Abdominal computed tomography (CT) revealed a pancreatic injury. Endoscopic retrograde pancreatography (ERP) showed complete disruption of the main pancreatic duct (MPD) in the body, which could not be managed by ERP-guided stenting of the distal duct. Surgical management was opted, and he was discharged on day 8 without any complications.

A 12-year-old boy presented with abdominal pain 2 days after being injured by an elbow strike in a handball game. Abdominal CT scan revealed pancreatic injury without pancreas-serosa rupture. ERP revealed complete disruption of the MPD in the body, which was successfully managed by ERP-guided stenting of the distal duct. Non-surgical management was opted in this case, and patient was discharged on day 15 without any complications.

Non-surgical management, including endoscopic stenting procedures, may be a less invasive and effective treatment option for selected patients with higher-grade pancreatic injuries.