Intraoperative ultrasonography is useful for diagnosing pancreatic duct injury and adjacent tissue damage in a patient with penetrating pancreas trauma.
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.
Hikida
Shigeki
S
Department of Surgery, Kurume University Hospital, Asahimachi 67, Kurume, Fukuoka 830-0011, Japan.
Sakamoto
Teruo
T
Higaki
Kensaku
K
Hata
Hirofumi
H
Maeshiro
Kanetaka
K
Yamauchi
Kenji
K
Kimura
Yuusuke Norman
YN
Egawa
Noriko
N
Mizote
Hiroyoshi
H
Shirouzu
Kazuo
K
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*