Management of a pancreatic duct injury with an endoscopically placed stent

Abstract

A 17-year-old woman was a belted, front-seat passenger in a head-on motor vehicle collision. On arrival at a local medical center, the patient was awake and alert with stable vital signs and complaining predominantly of abdominal and flank pain. Advanced Trauma Life Support protocol was followed. Laboratory evaluations were normal with the exception of a serum amylase greater than 1500 U/L (normal 28–100) and a serum lipase greater than 3000 U/L (normal 16–63). An urgent computed tomography (CT) scan of the abdomen and pelvis revealed a contusion of the left lateral segment of the liver and a fracture at the junction of the body and tail of the pancreas just lateral to the spine. There was no evidence of pancreatic necrosis. The patient was kept non per os (nothing by mouth) and showed a rapid normalization of her hyperamylasemia and hyperlipasemia during the next few days. She was discharged on hospital day 4, free of symptoms and tolerating a regular diet.