29 Pancreatic Transection

Clinical Presentation

A young woman presents to the emergency room with abdominal pain after sustaining blunt abdominal trauma in a motor vehicle accident.

Fig. 29.1 Axial contrast-enhanced CT image shows a high-density hematoma (arrow) dissecting the pancreatic body. The stranding in the anterior abdominal wall is consistent with a soft tissue contusion.

Radiologic Findings

An axial abdominal contrast-enhanced computed tomography (CT) scan image (Fig. 29.1) shows a high-density hematoma in the region of the pancreatic body. The stranding in the anterior abdominal wall is consistent with a soft tissue contusion.

Diagnosis

Pancreatic transection

Differential Diagnosis

None in the proper clinical setting

Discussion

Background

The pancreas is not as commonly involved in abdominal blunt trauma as the liver or spleen, but its injuries even if overlooked at an early CT scan can subsequently lead to life-threatening complications, especially in the setting of pancreatic duct rupture.