Clinical Case Database / Category: Patient Management
Blunt pancreatic trauma: an easily missed diagnosis in a young adult patient
MT Roach, MA Rathore, G Singh-Ranger, Dr Syed S Nasir
Foundation Years Journal, volume 9, issue 2, p.50 (123Doc Education, London, February 2015)
This case describes an acute presentation of a young patient with severe blunt abdominal trauma. However, because of her young age and massive physiological reserves, she was able to mask the severity of her signs and symptoms during a thorough physical examination. This resulted in the diagnosis of her pancreatic trauma being initially missed. It was her second presentation to the emergency department, two days later, when the severity of her symptoms and signs mandated an urgent CT scan. This showed a grade III pancreatic and liver trauma. She was managed conservatively at a hepatobiliary tertiary centre, with repeated imaging to check for any complications. She made a good recovery with conservative management.
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CT3 Emergency Medicine, North Tyneside General
Hospital, Rake Lane, North Shields, NE29 8NH.
Consultant General Surgeon, Department of Surgery,
Boston Pilgrim Hospital, Sibsey Road, Boston, Lincolnshire, PE21 9QS.
Consultant General Surgeon, Department of Surgery, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent, CT1 3NG.
Dr Syed S Nasir (Corresponding author)
Locum Speciality Registrar, Mid Staffordshire NHS Foundation Trust, Stafford Hospital, Weston Road, Stafford, ST16 3SA.
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