Endoscopic management of pancreatic duct injury by endoscopic stent placement: A case report and literature review

Yasuhiro Ito, Takeshi Kenmochi, Tomoyuki Irino, Tomohisa Egawa, Shinobu Hayashi, Atsushi Nagashima, Nao Hiroe, Mitsuhide Kitano, Yuukou Kitagawa

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Recently, the diagnostic evaluation of pancreatic injury has improved dramatically. On the other hand, it is occasionally difficult to diagnose pancreatic injury, because there are no specific signs, symptoms, or laboratory findings. Radiological imaging also often fails to identify pancreatic injury in the acute phase. Delayed diagnosis results in significant morbidity and mortality. Most cases of pancreatic injury with suspicion or pancreatic duct disruption require surgery. Endoscopic retrograde cholangiopancreatography is one of the most accurate modalities for ductal evaluation and therapy and might enable one to avoid unnecessary surgery. We describe endoscopic management of pancreatic duct injury by endoscopic stent placement. A 45-year-old woman was admitted after a traffic accident. A computed tomography scan showed pancreatic parenchyma disruption at the pancreatic head. Endoscopic retrograde cholangiopancreatography demonstrated disruption of the pancreatic duct with extravasation into the peripancreatic fluid collection. A 5-French endoscopic nasopancreatic drainage (ENPD) tube was placed. Her symptoms dramatically improved. ENPD tube was exchanged for a 5-French 5-cm pancreatic stent. Subsequent follow-up CT revealed remarkable improvement. On the 26th day, the patient was discharged from the hospital without symptoms or complications. In this report, a pancreatic stent may lead to rapid clinical improvement and enable surgery to be avoided. On the other hand, the reported complications of long-term follow-up make the role of stenting uncertain. Thus, close attention should be paid to stenting management in the follow-up period. A pancreatic stent is useful for pancreatic ductal injury. If pancreatic ductal injury is managed appropriately, a pancreatic stent may improve the clinical condition, and also prevent unnecessary surgery.

Original languageEnglish
Article number21
JournalWorld Journal of Emergency Surgery
Volume7
Issue number1
DOIs
Publication statusPublished - 2012 Jul 12

Fingerprint

Pancreatic Ducts
Stents
Wounds and Injuries
Unnecessary Procedures
Endoscopic Retrograde Cholangiopancreatography
Drainage
Traffic Accidents
Delayed Diagnosis
Signs and Symptoms
Tomography
Morbidity
Mortality

Keywords

  • Endoscopic
  • Endoscopic nasopancreatic drainage
  • Pancreatic injury
  • Pancreatic stent

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine

Cite this

Endoscopic management of pancreatic duct injury by endoscopic stent placement : A case report and literature review. / Ito, Yasuhiro; Kenmochi, Takeshi; Irino, Tomoyuki; Egawa, Tomohisa; Hayashi, Shinobu; Nagashima, Atsushi; Hiroe, Nao; Kitano, Mitsuhide; Kitagawa, Yuukou.

In: World Journal of Emergency Surgery, Vol. 7, No. 1, 21, 12.07.2012.

Research output: Contribution to journalArticle

Ito, Yasuhiro ; Kenmochi, Takeshi ; Irino, Tomoyuki ; Egawa, Tomohisa ; Hayashi, Shinobu ; Nagashima, Atsushi ; Hiroe, Nao ; Kitano, Mitsuhide ; Kitagawa, Yuukou. / Endoscopic management of pancreatic duct injury by endoscopic stent placement : A case report and literature review. In: World Journal of Emergency Surgery. 2012 ; Vol. 7, No. 1.
@article{f9158bc306ff46d1b69e9a79cdf42743,
title = "Endoscopic management of pancreatic duct injury by endoscopic stent placement: A case report and literature review",
abstract = "Recently, the diagnostic evaluation of pancreatic injury has improved dramatically. On the other hand, it is occasionally difficult to diagnose pancreatic injury, because there are no specific signs, symptoms, or laboratory findings. Radiological imaging also often fails to identify pancreatic injury in the acute phase. Delayed diagnosis results in significant morbidity and mortality. Most cases of pancreatic injury with suspicion or pancreatic duct disruption require surgery. Endoscopic retrograde cholangiopancreatography is one of the most accurate modalities for ductal evaluation and therapy and might enable one to avoid unnecessary surgery. We describe endoscopic management of pancreatic duct injury by endoscopic stent placement. A 45-year-old woman was admitted after a traffic accident. A computed tomography scan showed pancreatic parenchyma disruption at the pancreatic head. Endoscopic retrograde cholangiopancreatography demonstrated disruption of the pancreatic duct with extravasation into the peripancreatic fluid collection. A 5-French endoscopic nasopancreatic drainage (ENPD) tube was placed. Her symptoms dramatically improved. ENPD tube was exchanged for a 5-French 5-cm pancreatic stent. Subsequent follow-up CT revealed remarkable improvement. On the 26th day, the patient was discharged from the hospital without symptoms or complications. In this report, a pancreatic stent may lead to rapid clinical improvement and enable surgery to be avoided. On the other hand, the reported complications of long-term follow-up make the role of stenting uncertain. Thus, close attention should be paid to stenting management in the follow-up period. A pancreatic stent is useful for pancreatic ductal injury. If pancreatic ductal injury is managed appropriately, a pancreatic stent may improve the clinical condition, and also prevent unnecessary surgery.",
keywords = "Endoscopic, Endoscopic nasopancreatic drainage, Pancreatic injury, Pancreatic stent",
author = "Yasuhiro Ito and Takeshi Kenmochi and Tomoyuki Irino and Tomohisa Egawa and Shinobu Hayashi and Atsushi Nagashima and Nao Hiroe and Mitsuhide Kitano and Yuukou Kitagawa",
year = "2012",
month = "7",
day = "12",
doi = "10.1186/1749-7922-7-21",
language = "English",
volume = "7",
journal = "World Journal of Emergency Surgery",
issn = "1749-7922",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Endoscopic management of pancreatic duct injury by endoscopic stent placement

T2 - A case report and literature review

AU - Ito, Yasuhiro

AU - Kenmochi, Takeshi

AU - Irino, Tomoyuki

AU - Egawa, Tomohisa

AU - Hayashi, Shinobu

AU - Nagashima, Atsushi

AU - Hiroe, Nao

AU - Kitano, Mitsuhide

AU - Kitagawa, Yuukou

PY - 2012/7/12

Y1 - 2012/7/12

N2 - Recently, the diagnostic evaluation of pancreatic injury has improved dramatically. On the other hand, it is occasionally difficult to diagnose pancreatic injury, because there are no specific signs, symptoms, or laboratory findings. Radiological imaging also often fails to identify pancreatic injury in the acute phase. Delayed diagnosis results in significant morbidity and mortality. Most cases of pancreatic injury with suspicion or pancreatic duct disruption require surgery. Endoscopic retrograde cholangiopancreatography is one of the most accurate modalities for ductal evaluation and therapy and might enable one to avoid unnecessary surgery. We describe endoscopic management of pancreatic duct injury by endoscopic stent placement. A 45-year-old woman was admitted after a traffic accident. A computed tomography scan showed pancreatic parenchyma disruption at the pancreatic head. Endoscopic retrograde cholangiopancreatography demonstrated disruption of the pancreatic duct with extravasation into the peripancreatic fluid collection. A 5-French endoscopic nasopancreatic drainage (ENPD) tube was placed. Her symptoms dramatically improved. ENPD tube was exchanged for a 5-French 5-cm pancreatic stent. Subsequent follow-up CT revealed remarkable improvement. On the 26th day, the patient was discharged from the hospital without symptoms or complications. In this report, a pancreatic stent may lead to rapid clinical improvement and enable surgery to be avoided. On the other hand, the reported complications of long-term follow-up make the role of stenting uncertain. Thus, close attention should be paid to stenting management in the follow-up period. A pancreatic stent is useful for pancreatic ductal injury. If pancreatic ductal injury is managed appropriately, a pancreatic stent may improve the clinical condition, and also prevent unnecessary surgery.

AB - Recently, the diagnostic evaluation of pancreatic injury has improved dramatically. On the other hand, it is occasionally difficult to diagnose pancreatic injury, because there are no specific signs, symptoms, or laboratory findings. Radiological imaging also often fails to identify pancreatic injury in the acute phase. Delayed diagnosis results in significant morbidity and mortality. Most cases of pancreatic injury with suspicion or pancreatic duct disruption require surgery. Endoscopic retrograde cholangiopancreatography is one of the most accurate modalities for ductal evaluation and therapy and might enable one to avoid unnecessary surgery. We describe endoscopic management of pancreatic duct injury by endoscopic stent placement. A 45-year-old woman was admitted after a traffic accident. A computed tomography scan showed pancreatic parenchyma disruption at the pancreatic head. Endoscopic retrograde cholangiopancreatography demonstrated disruption of the pancreatic duct with extravasation into the peripancreatic fluid collection. A 5-French endoscopic nasopancreatic drainage (ENPD) tube was placed. Her symptoms dramatically improved. ENPD tube was exchanged for a 5-French 5-cm pancreatic stent. Subsequent follow-up CT revealed remarkable improvement. On the 26th day, the patient was discharged from the hospital without symptoms or complications. In this report, a pancreatic stent may lead to rapid clinical improvement and enable surgery to be avoided. On the other hand, the reported complications of long-term follow-up make the role of stenting uncertain. Thus, close attention should be paid to stenting management in the follow-up period. A pancreatic stent is useful for pancreatic ductal injury. If pancreatic ductal injury is managed appropriately, a pancreatic stent may improve the clinical condition, and also prevent unnecessary surgery.

KW - Endoscopic

KW - Endoscopic nasopancreatic drainage

KW - Pancreatic injury

KW - Pancreatic stent

UR - http://www.scopus.com/inward/record.url?scp=84863693179&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863693179&partnerID=8YFLogxK

U2 - 10.1186/1749-7922-7-21

DO - 10.1186/1749-7922-7-21

M3 - Article

C2 - 22788538

AN - SCOPUS:84863693179

VL - 7

JO - World Journal of Emergency Surgery

JF - World Journal of Emergency Surgery

SN - 1749-7922

IS - 1

M1 - 21

ER -