Diagnosis and Management of Pancreatic Trauma, from the Radiologist`s Screen to Multidisciplinary Management
2Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
Background
Pancreatic transection following high-impact blunt abdominal trauma carries devastating morbidity if diagnosis is delayed. While contrast-enhanced computed tomography angiography (CTA) is the gold standard for initial trauma triage, defining main pancreatic duct (MPD) integrity and identifying active retroperitoneal hemorrhage can remain highly challenging. We present a case of a 22 years-old female patient following a high-speed vehicle accident where a multimodality imaging approach—utilizing CTA, MRCP, ERCP and conventional digital subtraction angiography (DSA)—were critical in defining anatomy, assessing ductal disruption, and guiding multidisciplinary management.
OBJECTIVE
To demonstrate the importance of multimodality imaging in the diagnosis of blunt pancreatic trauma
DISCUSSION
This case underscores the distinct, complementary role of multimodality imaging in pancreatic trauma. CTA with portal venous phase is initial modality of choice for rapid assessment of injuries to the abdomen, including pancreatic injury grade. MRCP and ERCP were performed to further evaluate pancreatic injury, and attempted image-guided intervention.
Conventional angiography provides immediate transition from diagnosis to life-saving endovascular intervention for associated occult arterial pseudoaneurysm.
OBJECTIVE
To demonstrate the importance of multimodality imaging in the diagnosis of blunt pancreatic trauma
DISCUSSION
This case underscores the distinct, complementary role of multimodality imaging in pancreatic trauma. CTA with portal venous phase is initial modality of choice for rapid assessment of injuries to the abdomen, including pancreatic injury grade. MRCP and ERCP were performed to further evaluate pancreatic injury, and attempted image-guided intervention.
Conventional angiography provides immediate transition from diagnosis to life-saving endovascular intervention for associated occult arterial pseudoaneurysm.