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World J Gastrointest Surg. Jul 27, 2010; 2(7): 251-254
Published online Jul 27, 2010. doi: 10.4240/wjgs.v2.i7.251
Published online Jul 27, 2010. doi: 10.4240/wjgs.v2.i7.251
Traumatic pancreatic fistula with sinistral portal hypertension: Surgical management
Shoukat Ahmad Bojal, Kam Fung Leung, Abdul-Wahed Nasir Meshikhes, Department of Surgery, King Fahad Specialist Hospital, Dammam 31444, Saudi Arabia
Author contributions: Bojal SA, Leung KF and Meshikhes AWN contributed equally to this work.
Correspondence to: Abdul-Wahed Nasir Meshikhes, FRCS, Chairman and Consultant Surgeon, Department of Surgery, King Fahad Specialist Hospital, PO Box 15215, Dammam 31444, Saudi Arabia. meshikhes@gmail.com
Telephone: +966-3-8431111 Fax: 966-3-855 1019
Received: March 1, 2010
Revised: March 15, 2010
Accepted: March 22, 2010
Published online: July 27, 2010
Revised: March 15, 2010
Accepted: March 22, 2010
Published online: July 27, 2010
Abstract
Combined ductal and vascular injuries are awesome complications of pancreatic injury. We report on a 29-year-old male unrestrained driver who sustained a blunt abdominal injury from the steering wheel in a high velocity head-on car collision. He developed a pancreatic fistula, portosplenic venous thrombosis and sinistral portal hypertension as a result of complete duct disruption at the pancreatic neck. We describe a safe surgical strategy of spleen-preserving distal pancreatectomy after failed medical and endoscopic management.
Keywords: Spleen-preserving distal pancreatectomy, Pancreatic fistula, Portosplenic venous thrombosis, Sinistral portal hypertension