Isolated Pancreatic Transection Secondary to Abdominal Blunt Trauma - A Case Report

Abstract

An 8-year-old boy presented to the Emergency Department after trauma by a bicycle hand, with injury over inferior thoracic and epigastric region. GCS: 15/15. HR: 140/min. SPO2: 98%. Past medical history was not significant. Clinically, his abdomen was soft with tenderness over the left hypochondrium and tenderness with a patterned bruise of approximately 3*1 cms over the epigastrium. There were no features of peritonitis. Laboratory tests reported raised leucocytic count of 14,400 per dL and raised levels of serum amylase (1478 U/L). A contrast enhanced computed tomographic study of abdomen and pelvis suggested a large peripheral enhancing collection measuring approximately 37 (AP)*45 (TRANS)*55 (SI) mm replacing the entire thickness of neck of pancreas and extending into the peripancreatic fat over anterior aspect of head, neck, uncinate process and proximal body of pancreas, with eccentric non-enhancing hypodense area within representing blood clots. Final impression was that of a full thickness pancreatic laceration in neck with MPD injury-Grade III. Isolated pancreatic injury following blunt trauma to the abdomen, is not a common condition. Diagnosis can often be tricky, and it requires multiple investigations including blood reports, physical examination and radiological tests. The following report is a case of an 8-year-old male child who presented with a complete transection of the pancreas, following blunt abdominal trauma. Peptic perforation.  Intestinal perforation (small or large bowel).  Liver or splenic Injury.  Pancreatitis.  Rupture of pseudo-pancreatic cyst.  Rupture of liver abscess (subcapsular or intraperitoneal).  Gastritis with ulceration.