Open AccessCavitojejunostomy for post-traumatic disconnected pancreatic duct syndrome presenting as persistent external pancreatic fistula: A case report
Author(s) -
Kelu S Sreesanth,
V.K. Prathapan,
Mathew Joseph,
Chandran Nirmala Vyshakh
Publication year - 2021
Publication title -
indian journal of case reports
Language(s) - English
Resource type - Journals
eISSN - 2454-1303
pISSN - 2454-129X
DOI - 10.32677/ijcr.v7i11.3131
Subject(s) - medicine , pancreatic duct , pancreatic fistula , asymptomatic , pancreas , surgery , fistula , radiology , pancreatitis
Post-traumatic disconnected pancreatic duct syndrome (DPDS) can present as persistent external pancreatic fistula following percutaneous drainage (PCD) of pancreatic collection. Management of these cases can be difficult and involves a multidisciplinary approach. Here, we present a case of a 16-year-old boy who presented with persisted pancreatic fistula following initial management including PCD of peripancreatic collection following polytrauma 3 months prior. Magnetic resonance imaging showed a disconnected pancreatic duct. Intraoperatively, there was a disconnected and viable distal pancreas with a defect cavity measuring 2 × 2 cm at the neck of the pancreas. The wall of the cavity was anastomosed with a Roux limb of the jejunum (cavitojejunostomy). Post-operative recovery was uneventful and the patient remains asymptomatic at 2 months of follow-up. Cavitojejunostomy is a feasible and safe surgical option in DPDS with a well-formed cavity. This avoids dissection in difficult anatomical planes and preserves pancreatic parenchyma.