Current approach to traumatic hepato-pancreatico-duodenal injury: Report of a case and review of the literature
Journal Title: Ege Tıp Dergisi - Year 2014, Vol 53, Issue 2
Abstract
Traumatic pancreaticoduodenal injuries still have a high mortality rate and the treatment remains challenging for surgeons. Damage control has become an important part of trauma care nowadays. This approach is useable only in selected groups of trauma patients. An 18-year-old male was referred to our department because of motorcycle accident. Abdominal computed tomography (CT) demonstrated bilateral pleural effusion, a laceration in the right kidney, retroperitoneal hematoma, free air nearby the duodenum, complete transection of the pancreatic head and second portion of duodenum, and multiple lacerations in the right liver lobe. On laparotomy, the right lobe of the liver was divided with multiple lacerations. There was complete transection of the pancreatic head and second portion of the duodenum. We performed a right hepatectomy and whipple procedure. The patient was discharged from the hospital on the 31th postoperative day and has been stable and healthy during the one-year follow-up period. Traumatic pancreatic injuries are generally associated with other abdominal injuries. Several surgical treatment options can be considered for pancreaticoduodenal injuries. Damage control surgery is the modern approach in severe trauma patients. However, in selected patients, definitive surgery can be the optimal choice because of a one step approach, but patient selection must be performed carefully.
Authors and Affiliations
S Ozturk, L Yeniay, O V Unalp, M Unver, B Kibar Öztürk, O Bozbiyik
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