Presentation
Road traffic accident 6 weeks ago, with transection of head of pancreas. Follow up MRI and ultrasound studies revealed a peripancreatic collection. A CT study was requested to assess current status.
Patient Data
Complete transection of head of pancreas with identified as a hypodense area transecting the pancreatic parenchyma. A well defined pseudo walled peripancreatic (lesser sac) low density fluid collection is seen communicating at multiple points with the main pancreatic duct suggestive of multiple post traumatic fistulas.
Case Discussion
This is a case of post traumatic pancreatic fistulation secondary to parenchymal laceration injuring main pancreatic duct (AAST grade III). There is secondary amylase rich pseudocyst formation. Whilst the most common etiology of pseudocyst formation is acute or chronic pancreatic inflammation, trauma is another less common etiology that should be kept in mind. They tend to resolve over a period of time. Should they not, options of drainage or resection will need to be considered.
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