Combination therapy with early nasopancreatic drainage and minimum surgery for blunt high‐grade pancreatic trauma

Case A 22-year-old man suffered blunt, high-grade, pancreatic trauma; however, duct-related complications were avoided by combining early nasopancreatic drainage with minimal surgery. Endoscopic retrograde pancreatography confirmed rupture of the main pancreatic duct and massive retroperitoneal extravasation. A nasopancreatic catheter was placed across the rupture site, laparotomy was carried out, and a grade IV pancreatic head laceration was sutured. Because the nasopancreatic catheter shifted out intraoperatively, another was inserted and left in place for 12 days. Outcome The patient recovered well without any duct-related complications such as pseudocyst or external pancreatic fistula. Conclusion A combination of early therapeutic endoscopic retrograde pancreatography and surgical repair may be useful for treating high-grade pancreatic trauma when pancreatic resection is unnecessary.