Blunt pancreatic head hematoma as an infrequent cause of delayed obstructive jaundice.
BACKGROUND
Blunt pancreatic injury is a rare type of abdominal trauma. It is a challenge to physicians due to difficulties in early diagnosis and associated complications. Most simple cases of pancreas contusion and hematoma can be safely treated conservatively. Nevertheless, the possibility of delayed mass effect and complications always exists.


OBJECTIVE
We present a case with delayed complications after blunt pancreatic trauma.


METHODS
A 70-year-old woman with simple pancreatic head hematoma was treated conservatively. A delayed obstructive jaundice occurred 4 weeks subsequent to the trauma. Endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent placement provided a successful treatment instead of surgical intervention.


CONCLUSIONS
A pancreatic hematoma after blunt abdominal trauma can be complicated by common bile duct obstruction with a delayed onset of obstructive jaundice. The application of ERCP with placement of a biliary stent was effective in this case. Conscientious follow-up and serial imaging studies should be utilized in patients with an initial presentation of an uncomplicated pancreatic head hematoma.
Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
Chih-Yuan
CY
Fu
Shih-Chi
SC
Wu
Ray-Jade
RJ
Chen
Jui-Chein
JC
Huang
D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006406:Hematoma / Q000150:complications*; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D010179:Pancreas / Q000293:injuries*; D015607:Stents; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications*