Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6319-6324
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6319
Spontaneous healing after conservative treatment of isolated grade IV pancreatic duct disruption caused by trauma: A case report
Ming-Zhen Mei, Yu-Feng Ren, Yi-Ping Mou, Yuan-Yu Wang, Wei-Wei Jin, Chao Lu, Qi-Cong Zhu
Ming-Zhen Mei, Departments of General Surgery, Tiantai Campus of Zhejiang Provincial People’s Hospital, Taizhou 317200, Zhejiang Province, China
Yu-Feng Ren, Yi-Ping Mou, Yuan-Yu Wang, Wei-Wei Jin, Chao Lu, Qi-Cong Zhu, Department of General Surgery, Cancer Center, Division of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Yu-Feng Ren, Yi-Ping Mou, Yuan-Yu Wang, Wei-Wei Jin, Chao Lu, Qi-Cong Zhu, Key Laboratory of Gastroenterology of Zhejiang Province, Hangzhou 310014, Zhejiang Province, China
Author contributions: Mei MZ and Ren YF have contributed equally to this work; Mei MZ and Ren YF made substantial contributions to acquisition of data, analysis, and interpretation of data; Mou YP, Wang YY, Jin WW, Lu C, and Zhu QC made substantial contributions to the conception, acquisition of data, analysis, and interpretation of data; all authors have been involved in drafting the manuscript and revising it critically for important intellectual content; All authors read and approved the final manuscript and take public responsibility for appropriate portions of the content and agree to be accountable for all aspects of work.
Supported by Traditional Chinese medicine Science and Technology Project of Zhejiang Province, No. 2020ZB029.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and the accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Yu Wang, MD, PhD, Chief Doctor, Professor, Department of General Surgery, Cancer Center, Division of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. lywyy1979@126.com
Received: January 15, 2022
Peer-review started: January 15, 2022
First decision: April 8, 2022
Revised: April 10, 2022
Accepted: April 24, 2022
Article in press: April 24, 2022
Published online: June 26, 2022
Processing time: 152 Days and 16.4 Hours
Abstract
BACKGROUND

Trauma is a common cause of pancreatic duct disruption. Surgical treatment is recommended in current clinical guidelines for adult pancreatic injury because non-surgical treatments have higher risks of serious complications or even death compared with surgical treatment.

CASE SUMMARY

A 22-year-old woman was admitted to Tiantai People’s Hospital of Zhejiang Province after 1-h duration of abdominal pain and distension following trauma. The diagnosis was “traumatic pancreatic rupture”. The patient’s symptoms were not severe, her vital signs were stable, and signs of peritonitis were not obvious. Therefore, conservative treatment could be considered, with the possibility of emergency surgery if necessary. After 2 mo of conservative treatment with duct drainage, the pancreatic duct healed spontaneously with no significant complications.

CONCLUSION

We report a case of pancreatic duct disruption in the head and neck caused by trauma that was treated conservatively and healed spontaneously, providing a new choice for clinical practice. For isolated pancreatic injury with rupture of the pancreatic duct in the head and neck, conservative treatment under close observation is feasible.

Keywords: Trauma; Pancreatic ducts; Conservative treatment; Drainage; Case report

Core Tip: In this study, we report a case of pancreatic duct disruption in the head and neck caused by trauma that was treated conservatively and which healed spontaneously, providing a new basis for clinical practice. For isolated pancreatic injury with rupture of the pancreatic duct in the head and neck, conservative treatment under close observation is feasible.