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Pancreatic Injury Grade IV. and V.


Authors: V. Kuntscher;  T. Kural;  V. Třeška;  Martin Štěpán 1 ;  J. Ferda 2
Authors place of work: Chirurgická klinika Lékařská fakulta Plzeň, Univerzita Karlova Praha, FN Plzeň přednosta: prof. MUDr. V. Třeška, DrSc. ;  Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta Plzeň Univerzita Karlova Praha, FN Plzeň, přednosta: doc. MUDr. E. Kasal, CSc. 1;  Radiodiagnostická klinika Lékařská fakulta Plzeň, Univerzita Karlova Praha, FN Plzeň přednosta: doc. MUDr. B. Kreuzberg, CSc. 2
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 12, s. 651-653.
Category: Monothematic special - Original

Summary

In spite of being relatively rare, pancreatic injuries can have very serious consequences; morbidity and mortality of more severe pancreatic injuries that have not been recognized early and treated adequately is almost 100%.

We present the case of a 39-year-old man who sustained a stab wound (knife) that resulted in injuries to the vena cava inferior and right-sided renal vein, and cut through the duodenum, common bile duet, major pancreatic duet, and pancreatic head. This condition was treated initially by obtaining hemostasis – suture of the inferior vena cava and right-side renal vein, mobilization and tamponade of the pancreatic head, and ensuring drainage of bile through bile ducts, and then with proximal pancreatoduodenectomy.

Key words:
pancreas – duodenum – pancreatic injury – panereatoduodenectomy


Zdroje

1. Frey, C. F., Wardell, J. W., McMurtry, A. L. Injuries to the pancreas. In: Trede, M., Carter, D. C.: Surgery of the Pancreas second edition. Churchill Livingstone, 1997, pp. 609–633.

2. Graham, J. M., Mattox, K. L., Jordan, G. L. Jr. Traumatic injuries of the pancreas. American Journal of Surgery, 1978, 136: 744.

3. Glancy, K. E. Review of pancreatic trauma. Western Journal of Medicine, 1989, 151: 45.

4. Leppaniemi, A., Haapiainen, R., Kiviluoto, T., Lempinen, M. Pancreatic Trauma: acute and late manifestations. British Journal of Surgery, 1988, 75: 165.

5. Moore, E. E., et al. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. Journal of Trauma, 1990, 30: 1427.

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9. Jones, R. C. Management of pancreatic trauma. Annals of Surgery, 1978, 187: 555.

10. Wiesner, D. H., Wold, R. L., Frey, C. F. Diagnosis and treatment of pancreatic injuries: An anylasis of management principles. Archives of Surgery, 1990, 125: 1109.

11. Thompson, R. J. Jr, Hinshow, D. B. Pancreatic trauma review of 87 cases. Annals of Surgery, 1966, 163: 153.

12. Lopez, P. P., Benjamin, R., Cockburn, M., Amortegiu, J. D., Schulman, C. I., Soffer, D., Blackbourne, L. U., Habib, F., Jerokhimov, I., Trinkel, S., Coun, S. M. Recent trends in the management of combined pancreatoduodenal injuries. Am. Surg., 2005, Oct: 71(10): 547–552.

Štítky
Surgery Orthopaedics Trauma surgery

Článok vyšiel v časopise

Perspectives in Surgery

Číslo 12

2008 Číslo 12
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