Role of Endoscopic Retrograde Pancreatography (ERP) in Diagnosis and Treatment of Pancreatic Trauma: Case Report
Diagnosis of isolated pancreatic trauma is a clinical challenge because of its retroperitoneal location and no single diagnostic modality is highly specific and sensitive for pancreatic ductal injury. This article presented the benefit of endoscopic retrograde pancreatography (ERP) in diagnosis and therapeutic intervention in two patients who sustained blunt abdominal trauma and presented with equivocal clinical manifestation of pancreatic ductal injury.
Case 1: a 20 year-old man sustaining blunt abdominal trauma presented with minimal abdominal symptoms and signs whilst computer tomography (CT) showed features suggesting laceration of pancreatic head area. ERP revealed partial disruption of the main pancreatic duct and injected contrast media accumulated within pancreatic parenchymal tissue. The patient responded very well to conservative treatment and no complication detected during the two years of follow-up.
Case 2: a 45 year-old man developed severe abdominal pain which needed six hospitalizations within six months after negative abdominal exploration for blunt abdominal trauma. CT showed a 4x6cm size of pancreatic pseudocyst at the head of pancreas. ERP revealed complete disruption of main pancreatic duct. Endoscopic transpapillary drainage was successfully performed. He had no significant abdominal pain or other complication during four years of follow-up.
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