Emergent endoscopic retrograde cholangiopancreatography. A highly specific test for acute pancreatic trauma

S. R. Hayward, C. E. Lucas, C. Sugawa and A. M. Ledgerwood
Department of Surgery, Wayne State University, Detroit, MI.

Emergent endoscopic retrograde cholangiopancreatography (ERCP) was assessed as the definitive diagnostic test for acute pancreatic injury in a 23-year-old male automobile driver who sustained blunt abdominal trauma. Despite the patient's quiet, tender abdomen, rising serum amylase level, and an abdominal computed tomographic scan demonstrating probable pancreatic transection, a nonoperative approach was successful when an emergency ERCP demonstrated normal ductal anatomy. This approach is advocated when the presence of a possible pancreatic injury is the only reason for a planned exploratory laparotomy.