Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report
Abstract Background A high-grade pancreatic injury is a life-threatening injury that is associated with high mortality and morbidity. It is currently unclear which treatment strategy results in good clinical outcomes. Case presentation A 23-year-old Japanese woman sustained severe injury in a motor...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-021-02995-z |
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| author | Futoshi Nagashima Satoshi Inoue Daisaku Matsui Yuki Bansyoutani Rina Tokuda Osamu Fuzisaki Makoto Kobayashi |
| author_facet | Futoshi Nagashima Satoshi Inoue Daisaku Matsui Yuki Bansyoutani Rina Tokuda Osamu Fuzisaki Makoto Kobayashi |
| author_sort | Futoshi Nagashima |
| collection | DOAJ |
| description | Abstract Background A high-grade pancreatic injury is a life-threatening injury that is associated with high mortality and morbidity. It is currently unclear which treatment strategy results in good clinical outcomes. Case presentation A 23-year-old Japanese woman sustained severe injury in a motor vehicle accident. Abdominal computed tomography revealed severe pancreatic head injury with extravasation of contrast media. Since it was not possible to insert an endoscopic pancreatic stenting tube into the main pancreatic duct, damage control surgery was performed. On day 3, we could insert the endoscopic pancreatic stenting tube from the ampulla of Vater and an endoscopic nasopancreatic drainage tube in the distal pancreatic duct from the accessory ampulla before the second operation. Drainage tubes were placed around the pancreatic head in the second operation. The endoscopic nasopancreatic drainage tube tube was converted to endoscopic pancreatic stenting tube on day 9. On day 51, the patient was discharged on foot from our hospital without serious complications. Conclusion Early and effective hemostasis, staged pancreatic duct drainage with stenting, and surgical external drainage around the pancreas in combination with an endoscopic procedure and damage control surgery were considered appropriate therapeutic strategy for high-grade pancreatic injury. |
| first_indexed | 2024-12-13T21:47:53Z |
| format | Article |
| id | doaj.art-b6fd8d5faf9b4f028fa0b653e29042ac |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-13T21:47:53Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-b6fd8d5faf9b4f028fa0b653e29042ac2022-12-21T23:30:22ZengBMCJournal of Medical Case Reports1752-19472021-08-011511810.1186/s13256-021-02995-zEfficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case reportFutoshi Nagashima0Satoshi Inoue1Daisaku Matsui2Yuki Bansyoutani3Rina Tokuda4Osamu Fuzisaki5Makoto Kobayashi6Tajima Emergency and Critical Care Medical Center, Toyooka Public HospitalInoue ClinicTajima Emergency and Critical Care Medical Center, Toyooka Public HospitalTajima Emergency and Critical Care Medical Center, Toyooka Public HospitalTajima Emergency and Critical Care Medical Center, Toyooka Public HospitalTajima Emergency and Critical Care Medical Center, Toyooka Public HospitalTajima Emergency and Critical Care Medical Center, Toyooka Public HospitalAbstract Background A high-grade pancreatic injury is a life-threatening injury that is associated with high mortality and morbidity. It is currently unclear which treatment strategy results in good clinical outcomes. Case presentation A 23-year-old Japanese woman sustained severe injury in a motor vehicle accident. Abdominal computed tomography revealed severe pancreatic head injury with extravasation of contrast media. Since it was not possible to insert an endoscopic pancreatic stenting tube into the main pancreatic duct, damage control surgery was performed. On day 3, we could insert the endoscopic pancreatic stenting tube from the ampulla of Vater and an endoscopic nasopancreatic drainage tube in the distal pancreatic duct from the accessory ampulla before the second operation. Drainage tubes were placed around the pancreatic head in the second operation. The endoscopic nasopancreatic drainage tube tube was converted to endoscopic pancreatic stenting tube on day 9. On day 51, the patient was discharged on foot from our hospital without serious complications. Conclusion Early and effective hemostasis, staged pancreatic duct drainage with stenting, and surgical external drainage around the pancreas in combination with an endoscopic procedure and damage control surgery were considered appropriate therapeutic strategy for high-grade pancreatic injury.https://doi.org/10.1186/s13256-021-02995-zPancreatic head injuryEndoscopic retrograde pancreatography (ERP)Damage control surgery (DCS)Endoscopic nasopancreatic drainage (ENPD)Endoscopic pancreatic stenting tube (EPST) |
| spellingShingle | Futoshi Nagashima Satoshi Inoue Daisaku Matsui Yuki Bansyoutani Rina Tokuda Osamu Fuzisaki Makoto Kobayashi Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report Journal of Medical Case Reports Pancreatic head injury Endoscopic retrograde pancreatography (ERP) Damage control surgery (DCS) Endoscopic nasopancreatic drainage (ENPD) Endoscopic pancreatic stenting tube (EPST) |
| title | Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report |
| title_full | Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report |
| title_fullStr | Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report |
| title_full_unstemmed | Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report |
| title_short | Efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury: a case report |
| title_sort | efficacy of damage control surgery and staged endoscopic pancreatic ductal double stenting therapy for severe pancreatic head injury a case report |
| topic | Pancreatic head injury Endoscopic retrograde pancreatography (ERP) Damage control surgery (DCS) Endoscopic nasopancreatic drainage (ENPD) Endoscopic pancreatic stenting tube (EPST) |
| url | https://doi.org/10.1186/s13256-021-02995-z |
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