LAPAROSCOPIC DISTAL PANCREATECTOMY FOR ISOLATED PANCREATIC INJURY IN BLUNT ABDOMINAL TRAUMA – A CASE REPORT

Abstract

Pancreatic injury presenting as an isolated injury in the pediatric population is rare. Unlike other solid organ injuries, these injuries may be subtle and difficult to diagnose. The management options vary from conservative management for low-grade injuries to surgical management for high-grade injuries; The optimal course of treatment is best determined by the severity of the injury and its clinical presentation. Laparoscopic distal pancreatectomy has increasingly been described as a feasible procedure for the surgical management of such injuries.
Here we present our experience with a twelve-year-old boy with epigastric pain for eighteen hours following a road traffic accident. He was hemodynamically stable with no external signs of injury, and investigations were initially normal, but later he developed leukocytosis and hyperamylasemia; a repeat contrast-enhanced computed tomography (CECT) diagnosed an isolated grade III pancreatic injury. The case was initially managed non-operatively, but a laparoscopic distal pancreatectomy was later performed due to an acute abdomen caused by generalized peritonitis.
Laparoscopic distal pancreatectomy can be a safe and valuable surgical option when the surgical approach is considered for pancreatic injury. Laparoscopic distal pancreatectomy has been associated with an overall decrease in morbidity.