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JOP. 2012 Mar 10;13(2):187-92.

Endoscopic management of pancreatic injury due to abdominal trauma.

Author information

1
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India. deepakkbhasin@gmail.com

Abstract

CONTEXT:

There is limited experience with pancreatic endotherapy in patients with pancreatic injury due to trauma.

OBJECTIVE:

To retrospectively evaluate our experience of endoscopic management of pancreatic trauma.

PATIENTS:

Eleven patients (10 males and 1 female; mean age: 21.8±11.9 years) with pancreatic trauma.

INTERVENTION:

Endoscopic therapy. Patients with pseudocyst and a gastroduodenal bulge were treated with endoscopic transmural drainage. Pseudocysts without bulge or patients with external pancreatic fistula were treated with transpapillary drainage.

RESULTS:

Seven patients (6 males, 1 female) were treated for symptomatic pseudocyst and 4 patients (all males) were treated for persistent external pancreatic fistula. Three patients with external pancreatic fistula had partial disruption of pancreatic duct (head: 2 cases; tail: 1 case) and were successfully treated with bridging pancreatic stent (2 cases) or bridging nasopancreatic drain (1 case) with resolution of external pancreatic fistula in 4 to 6 weeks. Of seven patients presenting with symptomatic pseudocyst (size range: 4-14 cm), two patients were successfully treated with cystogastrostomy and there has been no recurrence over a follow up of 20 and 16 months, respectively. Five patients underwent transpapillary drainage. Three patients had partial disruption and two had complete disruption. In the former, a bridging nasopancreatic drain was placed in one patient and stent in two patients. All three patients had resolution of pseudocyst within 8 weeks and there has been no recurrence over a follow-up of 11 to 70 months. In two patients with complete disruption, non-bridging stent did not resolve the pseudocysts and required surgery.

CONCLUSION:

Pancreatic injury due to trauma can be effectively treated endoscopically.

PMID:
22406599
[Indexed for MEDLINE]
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