Pancreatic injury in the wake of severe abdominal trauma

Abstract

Pancreatic trauma is a relatively rare occurrence but presents significant challenges due to the organ's retroperitoneal location and intricate anatomical relationships. This case report explores the management of a Grade III pancreatic injury in the context of established trauma and surgical guidelines. A 20-year-old male patient presented with severe abdominal trauma following a motor vehicle accident. He exhibited signs of severe blunt abdominal trauma, leading to the diagnosis of a complete pancreatic fracture, along with other intra-abdominal injuries. An urgent laparotomy was performed, and distal pancreatectomy with splenic preservation was executed to address the pancreatic injury. Postoperatively, the patient developed a low-output pancreatic fistula, which was managed conservatively with a surgical approach. However, he later presented with small bowel obstruction due to severe enterocolic adhesion to the fistula tract. This case emphasizes the critical role of guidelines and evidence-based practices in optimizing patient outcomes following abdominal trauma, particularly in the management of pancreatic injuries. Timely recognition and intervention, adherence to recognized guidelines, and vigilance in managing postoperative complications all play key roles in enhancing patient care and outcomes. Lessons from cases of delayed small bowel stenosis underscore the importance of timely diagnosis and intervention in traumatic injuries.