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Stumpfes Bauchtrauma bei einer 18-jährigen Patientin

Blunt abdominal trauma in an 18-year-old woman

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Zusammenfassung

Der Erhalt des Ductus Wirsungianus ist prognoseentscheidend nach Pankreasruptur bei stumpfem Bauchtrauma. Die endoskopische retrograde Pankreatikographie (ERP) ist hier nicht nur diagnostisch, sondern ermöglicht auch eine minimalinvasive Therapie. Wir berichten über die endoskopische Versorgung einer Pankreasgangruptur bei einer 18-jährigen Patientin. In der initalen CT bestand der Verdacht auf eine komplette Pankreasruptur. Die dringlich durchgeführte ERP zeigte jedoch ein auf das Parenchym beschränktes Kontrastmittelextravasat. Über die Ruptur konnte drahtgeführt ein Stent in die intakten distalen Abschnitte eingebracht werden. Die Patientin erholte sich unter konservativer Therapie vollständig. Der Stent wurde nach 6 Wochen entfernt. Dieser Fallbericht zeigt, dass durch die endoskopische Versorgung bei ausgewählten Patienten die Pankreasresektion umgangen werden kann.

Abstract

The integrity of the main pancreatic duct (MPD) is the most important determinant of outcome after pancreatic injury from blunt abdominal trauma. Endoscopic retrograde pancreatography (ERP) is the most accurate diagnostic tool and may moreover provide a minimally invasive therapy. We report on stenting in MPD rupture in an 18-year-old woman. Total pancreatic disruption was suspected on the initial CT. Emergency ERP revealed MPD leakage confined to the parenchyma. A transpapillary stent was wire-guided inserted into the intact duct of the distal section, bridging the disruption. The patient was managed conservatively and recovered completely. The stent was removed after 6 weeks. This case report demonstrates that pancreatic resection can be avoided by endoscopic treatment.

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Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland

    M. Goetz & M. Schuchmann

  2. Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Universitätsmedizin Mainz, Mainz, Deutschland

    A.D. Rink

  3. Klinik und Poliklinik für diagnostische und interventionelle Radiologie, Universitätsmedizin Mainz, Mainz, Deutschland

    K.K. Gast

Authors
  1. M. Goetz
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  2. A.D. Rink
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  3. K.K. Gast
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  4. M. Schuchmann
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Correspondence to M. Goetz.

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Goetz, M., Rink, A., Gast, K. et al. Stumpfes Bauchtrauma bei einer 18-jährigen Patientin. Gastroenterologe 6, 328–332 (2011). https://doi.org/10.1007/s11377-011-0542-0

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