title: Delayed presentation of isolated complete pancreatic transection as a result of sport-related blunt trauma to the abdomen.
abstract: Blunt abdominal trauma is a rare but well-recognized cause of pancreatic transection. A delayed presentation of pancreatic fracture following sport-related blunt trauma with the coexisting diagnostic pitfalls is presented.
  
  
  
  A 17-year-old rugby player was referred to our specialist unit after having been diagnosed with traumatic pancreatic transection, having presented 24 h after a sporting injury. Despite haemodynamic stability, at laparotomy he was found to have a diffuse mesenteric hematoma involving the large and small bowel mesentery, extending down to the sigmoid colon from the splenic flexure, and a large retroperitoneal hematoma arising from the pancreas. The pancreas was completely severed with the superior border of the distal segment remaining attached to the splenic vein that was intact. A distal pancreatectomy with spleen preservation and evacuation of the retroperitoneal hematoma was performed.
  
  
  
  Blunt pancreatic trauma is a serious condition. Diagnosis and treatment may often be delayed, which in turn may drastically increase morbidity and mortality. Diagnostic difficulties apply to both paraclinical and radiological diagnostic methods. A high index of suspicion should be maintained in such cases, with a multi-modality diagnostic approach and prompt surgical intervention as required.
authors.affiliation: HPB Surgery, Division of Surgery, Oncology, Reproductive Biology and Anesthetics, Imperial College of Science, Technology and Medicine, Hammersmith Hospital Campus, London, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Healey
authors.forename: Iannis
authors.initials: I
authors.lastname: Dimarakis
authors.forename: Madhava
authors.initials: M
authors.lastname: Pai
authors.forename: Long R
authors.initials: LR
authors.lastname: Jiao