title: Intraoperative ultrasonography is useful for diagnosing pancreatic duct injury and adjacent tissue damage in a patient with penetrating pancreas trauma.
abstract: We report a case of pancreatic injury, caused by a stab wound, in which ductal injury and wound depth were clearly identified by intraoperative ultrasonography. A 65-year-old woman was emergently admitted to our hospital after stabbing herself in the abdomen in a suicide attempt. Preoperative computed tomography (CT) and laboratory examination revealed liver and pancreatic injury with massive abdominal bleeding and free air. Operative findings included injuries of the stomach, small bowel, colon, liver, and pancreas. The pancreatic lacerations were 1 cm in length, in the body. Intraoperative ultrasonography enabled the diagnosis of a lacerated main pancreatic duct with no damage to the major vessels posterior to the pancreas. Distal pancreatectomy; simple repairs of the liver, small bowel, and stomach; exteriorization of the injured colon; cholecystostomy; gastrostomy; and jejunostomy were performed. The patient recovered and was transferred to a psychiatric hospital 87 days after surgery. In this patient, intraoperative ultrasonography was successfully used to identify the degree of injury to the pancreatic duct, as well as the depth of the stab wound. In conclusion, intraoperative ultrasonography should be routinely performed to detect main pancreatic duct injury in penetrating pancreatic trauma.
authors.affiliation: Department of Surgery, Kurume University Hospital, Asahimachi 67, Kurume, Fukuoka 830-0011, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hikida
authors.forename: Teruo
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kensaku
authors.initials: K
authors.lastname: Higaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hata
authors.forename: Kanetaka
authors.initials: K
authors.lastname: Maeshiro
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Yuusuke Norman
authors.initials: YN
authors.lastname: Kimura
authors.forename: Noriko
authors.initials: N
authors.lastname: Egawa
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Mizote
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000368:Aged; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D022125:Lacerations / Q000000981:diagnostic imaging / Q000601:surgery; D008099:Liver / Q000293:injuries; D010180:Pancreatectomy; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014951:Wounds, Stab / Q000000981:diagnostic imaging*