CASI CLINICI   

Minerva Chirurgica 2014 April;69(2):107-12

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Combined duodenal and pancreatic major trauma in high risk patients: can a partial reconstruction be safe?

Toro A. ¹, Li Destri G. ², Mannino M. ³, Arcerito M. C. ⁴, Ardiri A. ⁵, Politi A. ³, Bertino G. ⁵, Di Carlo I. ^{3, 6} ✉

¹ Department of Surgery, Taormina Hospital, Messina, Italy; ² Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Policlinico Hospital, Catania, Italy; ³ Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, Catania, Italy; ⁴ University of Catania, Catania, Italy; ⁵ Department of Internal Medicine and Systemic Disease, Hepatology Unit, University of Catania, S. Marta Hospital, Catania, Italy; ⁶ Department of Surgery, Hamad Medical Corporation, Doha, Qatar

Pancreatic trauma is an uncommon injury, occurring in only about 0.2% of blunt abdominal injuries, while duodenal injuries represent approximately 4% of all blunt abdominal injuries. When trauma of the pancreas and duodenum do not permit reparation, pancreatoduodenectomy (PD) is mandatory. In the reconstructive phase, the use of ductal ligation as an alternative to standard pancreaticojejunostomy has been reported by some authors. We report a case of polytrauma with pancreatic and duodenal injury in which the initial diagnosis failed to recognize the catastrophic duodenal and pancreatic situation. The patient was submitted for PD and the pancreatic stump was abandoned in the abdominal cavity after main pancreatic ductal ligation. This technique can minimize the morbidity and mortality of PD in patients with other organs or apparatus involved severely and extensively in trauma.