[Combined management of pancreatic injury after airgunshot--case report].
Pancreatic trauma is a big diagnostic and therapeutic challenge for physicians. Because of retroperitoneal localization pancreas is protected from damages. Isolated pancreatic injury is rare. Usually it is connected with a multiple trauma. Damages of the other organs mask the symptoms of pancreas disorders and delay the diagnosis. On the other hand the prognosis is strictly connected with the state of the other organs. Early diagnosis and precise evaluation of the trauma extensiveness determines the appropriate method of the treatment. Surgery is a main therapy but the combined method of management is often necessary, including endoscopy. Computed tomography (CT) is the first diagnostic method showing the pancreatic parenchymas damage and its complications. Endoscopic Retrograde Cholangiopancreatography (ERCP) is the best tool to show the major ductal injury. The status of the major pancreas duct determines surgery management. Often the placement of stents is required. This therapy can save the patient from pancreatectomy. In this article was depicted a case of 19th patient with pancreatic injury who sustained airgun shot. Despite laparotomy and surgery external drainage the pancreatocutaneous fistula appeared. It was successfully treated by endoscopic placement of stent during ERCP.
Babski
Paweł
P
Military Institute of Health Services in Warsaw, Central Clinical Hospital of the Ministry of National Defense, Department of Gastroenterology with Endoscopy Unit. babapa@o2.pl
Dziekiewicz
Mirosław
M
Gil
Jerzy
J
Wojtuń
Stanisław
S
Maruszyński
Marek
M
D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004724:Endoscopy; D006801:Humans; D007813:Laparotomy; D008297:Male; D010179:Pancreas / Q000293:injuries*; D010180:Pancreatectomy; D015607:Stents; D014948:Wounds, Gunshot / Q000175:diagnosis* / Q000601:surgery*