Abstract
Pancreatic pseudocyst caused by trauma is rare. Only in 5 of 98 patients on whom we operated between 1977 and 1991 for pancreatic pseudocyst were we able to detect previous blunt abdominal trauma. In a 4-year-old girl just a slight abdominal trauma had given rise to a cyst, while in 2 other patients (aged 9 and 26 years) pancreatitis occurred after trauma that was treated medically. Two patients had to undergo laparotomy immediately after suffering serious abdominal blunt injury. Diagnosis was established sonographically, except in one case, in which a large cyst was determined to originate from the pancreas, but only intraoperatively. The time-span between trauma and treatment of the pseudocyst ranged from 3 months to 1 year. Thus, continuous percutaneous suction, which is basically considered a promising therapy for cysts in their early stages of development, was obviously not feasible in our patients. We therefore carried out cystojejunostomy with formation of a Rouxen-Y jejunum loop. At follow up 1–10 years after operation, all patients were asymptomatic and no cyst formation could be detected sonographically.
Zusammenfassung
Traumatische Pankreaspseudozysten sind selten. Nur bei 5 der 98 Patienten, die wir zwischen 1977 and 1991 wegen einer Pankreaspseudozyste operierten, war ein Unfall vorausgegangen. Bei einem 4 Jahre alten Kind ging der Entstehung der Zyste ein stumpfes Bauchtrauma voraus, dem keine Beachtung geschenkt worden war. Zwei Patienten, 9 und 26 Jahre alt, hatten eine Pakreatitis, die zunächst konservativ behandelt wurde. Zwei Patienten, 16 and 17 Jahre alt, waren wegen intraabdominalen Verletzungen sofort laparotomiert worden. Die Diagnose ließ sich bis auf einen Fall, wo die Zuordnung der riesigen Zyste zur Bauchspeicheldrüse erst intraoperativ gelang, durch die Ultraschalluntersuchung sichern. Das Intervall zwischen dem Unfall und der Operation betrug 3 Monate bis zu 1 Jahr. Dieses lange Intervall erklärt, daß die bei akuten Pseudozysten erfolgversprechende perkutane Dauersogbehandlung bei unseren Patienten nicht in Frage kam. Wir drainierten bei alien Patienten die Zyste in eine ausgeschaltete Jejunumschlinge. Bei der Nachuntersuchung 1–10 Jahre nach der Zystojejunostomie waren alle Patienten beschwerdefrei, eine Zyste war sonographisch nicht mehr nachweisbar.
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Zimmermann, T., Henneking, K., Kelm, C. et al. Pankreaspseudozysten nach stumpfen bauchtraumata. Langenbecks Arch Chir 378, 102–105 (1993). https://doi.org/10.1007/BF00202117
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DOI: https://doi.org/10.1007/BF00202117