Sequential CT evaluation of isolated non-penetrating pancreatic trauma

Isolated pancreatic injuries resulting from non-penetrating trauma are rare. CT is currently the modality of choice in evaluating pancreatic injury. Delay in recognizing patients who need immediate surgery is an important cause of increased morbidity due to specific pancreatic complications. A 47-year-old man with blunt abdominal trauma after a car accident underwent a CT scan. Initial CT findings included diffuse pancreatic enlargement suggestive of isolated grade 1 pancreatic injury. A follow-up CT scan 3 days later revealed a fracture line at the pancreatic body. Subsequent surgical exploration confirmed the suspicion of concomitant duct transection. Seven months after surgery, a pseudocyst had formed adjacent to the site of the injury. This case demonstrates the potential importance of serial CT scans in the diagnosis, grading and management of isolated pancreatic injury.