Journal article
Post-traumatic pancreatico-dural fistula: Case report and management challenges.
- Tarabay AW Neurosurgery Division, Neurosciences Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- Rocca A Neurosurgery Division, Neurosciences Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- Martin D Visceral Surgery Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- Zingg T Visceral Surgery Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- Halkic N Visceral Surgery Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- Leviver M Neurosurgery Division, Neurosciences Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- Daniel RT Neurosurgery Division, Neurosciences Department, CHUV (Centre Hospitalier Universitaire Vaudois), UNIL University, Lausanne, Switzerland.
- 2018-06-27
Published in:
- Trauma case reports. - 2016
English
Pancreatic injury can occur following high-energy blunt trauma to the torso. Although several types of pancreatic fistulas have been described in literature, we report to our knowledge, the first case of a pancreatico-dural fistula of traumatic origin. A 20-year-old male sustained a severe blow to the thoraco-abdominal region in the setting of a motorcycle accident. A total body scan revealed an AAST (American Association for the Surgery of Trauma) grade 4 splenic injury. A laparotomy with splenectomy and abdominal packing was performed. This was later followed by thoracolumbar instrumentation for posterior fixation of a T11-T12 transdiscal type C fracture with anterior subluxation of T11, according to the AO classification. Subsequent management was complicated by the persistence of a pseudomeningocele despite multiple surgical drainage procedures and a concomitant increase in retroperitoneal fluid collections. High levels of amylase and lipase in the pseudomeningocele fluid confirmed the presence of a pancreatico-dural fistula, due to a Wirsung duct rupture. This case report illiustrates the challenges in the management of this rare condition.
- Language
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- English
- Open access status
- gold
- Identifiers
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- DOI 10.1016/j.tcr.2016.09.002
- PMID 29942848
- Persistent URL
- https://sonar.ch/global/documents/277996
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