Central pancreatectomy for pancreatic trauma in a Teenager: A case report

Management for high-grade pancreatic neck trauma is controversial, with distal pancreatectomy being the typical operative approach despite potential metabolic consequences, while central pancreatectomy, though well-described in elective surgery, is seldom performed in pediatric trauma. A 13-year-old previously healthy boy presented with epigastric abdominal pain following a bicycle accident. Physical examination revealed epigastric bruising and tenderness. Contrast-enhanced computed tomography demonstrated a complete transection at the pancreatic neck, consistent with a grade IV pancreatic injury, and serum amylase levels were markedly elevated. Surgical management was indicated, and intraoperative findings showed a near-complete transection of the pancreatic neck without associated injuries. A central pancreatectomy was performed, followed by Roux-en-Y pancreatojejunostomy using the Blumgart’s technique over an intraductal stent. The postoperative course was uneventful, with early return of bowel function and no evidence of pancreatic fistula. The patient was discharged on postoperative day nine. At five-month follow-up, he remained asymptomatic, and ultrasonography confirmed the absence of complications. Central pancreatectomy seems to be a safe and effective management option for children who have a complete traumatic transection of the pancreatic neck.