Presentation
Road traffic collision. Rear seat passenger. Tender upper abdomen.
Patient Data
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There is a linear focal area of non-enhancement in the body of the pancreas. Peri-pancreatic fat stranding and minimal free fluid which extends to the left upper quadrant and in the pelvis. There is a high suspicion of pancreatic ductal injury hence the appearances are in keeping with a grade III pancreatic injury as per the American Association for Surgery in Trauma (AAST).
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Associated superior end plate of L3 fracture.
Axial and coronal images marking shows the pancreatic laceration site.
Case Discussion
Trauma to the pancreas is classified using the American Association for Surgery in Trauma (AAST) system.
Grade 3 as in this case involves the pancreatic body and associated with ductal injury. Grade 4 and 5 tend to disrupt the head/uncinate process and associated with injury to the bile duct/ampulla.
Case also contributed by Dr A Kraus.