Pancreatic laceration

Case contributed by Dr Henry Knipe

Presentation

Motorbike accident. Upper abdominal pain. FAST negative.

Patient Data

Age: 50 years
Gender: Male
CT

Fat stranding and small volume of blood within the left upper quadrant and left retroperitoneal space. A linear hypodensity is seen through the tail of the pancreas. Dense left adrenal nodule most likely represents a haematoma in this context. There is a small left perinephric haematoma. 

Annotated image
  • Blue arrow = linear hypodensity through oedematous pancreatic tail reflecting a pancreatic laceration. 
  • Yellow arrow = left adrenal nodule, presumably a haematoma. 
  • Red arrow = peripancreatic fluid, fat stranding and haematoma. 

Case Discussion

This pancreatic laceration was managed non-operatively, although the patient did go on to develop a pseudocyst. 

Pancreatic lacerations can be difficult to identify but as in this case, there are a few subtle clues such as pancreatic oedema, linear hypodensity, as well as surrounding fat stranding and fluid/haematoma. 

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Case information

rID: 42477
Case created: 21st Jan 2016
Last edited: 19th Jun 2017
Inclusion in quiz mode: Included

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