title: A drainage operation for injury to the pancreas preserved the distal pancreas, spleen and the residual stomach after distal gastrectomy: a case report.
abstract: We experienced a case in which a drainage operation for injury of the pancreas preserved the distal pancreas, spleen and the residual stomach after distal gastrectomy for complete laceration of the stomach. A 23-year-old male was crushed by a large truck while driving a car without a seat belt. Abdominal computed tomography (CT) scan showed a low-density area in and around the body of the pancreas, which suggested contusion of the pancreatic parenchyma. An emergent operation was indicated due to free air and massive bleeding in the abdominal cavity and liver damage. At the operation, the antrum of the stomach was completely lacerated and distal gastrectomy was performed. Drains were set around the body of the pancreas. Distal pancreatectomy with splenectomy would have led to total gastrectomy because of lack of blood supply to the residual stomach after distal gastrectomy. We limited the drainage operation for pancreatic trauma. As a result, the pancreatic body and tail were preserved, which is thought to be a much better long-term result for this patient.
authors.affiliation: Department of Gastroenterological and General Surgery, Yamagata University School of Medicine Yamagata, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Watanabe
authors.forename: Wataru
authors.initials: W
authors.lastname: Kimura
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Yano
authors.forename: Osamu
authors.initials: O
authors.lastname: Hachiya
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Ma
authors.forename: Akira
authors.initials: A
authors.lastname: Fuse
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance; D003288:Contusions / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005743:Gastrectomy; D018530:Gastric Stump; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D008297:Male; D010179:Pancreas / Q000293:injuries*; D013270:Stomach / Q000293:injuries*