Pancreatic Laceration and Bicycle

Letter to Editor

Pancreatic Laceration and Bicycle

Yaser Kaplan
Ali Karakus ^*

Hatay Mustafa Kemal University, Faculty of Medicine, Emergency Medicine, Hatay, Turkey.

*Corresponding Author: Ali Karakus, Hatay Mustafa Kemal University, Faculty of Medicine, Emergency Medicine, Hatay, Turkey.

Citation: Kaplan Y, Karakus A. (2024). Pancreatic Laceration and Bicycle. Journal of Clinical Surgery and Surgical Research, BioRes Scientia Publishers. 3(3):1. DOI: 10.59657/2992-9989.brs.24.031

Copyright: © 2024 Ali Karakus, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: October 29, 2024 | Accepted: November 15, 2024 | Published: November 20, 2024

Abstract

Keywords: pancreatic laceration; bicycle; abdominal tomography

Letter to Editor

Dear Editor,

Isolated pancreatic injuries are very rare, usually occurring in children after falling from a bicycle and the handlebars hitting the abdomen. In pancreatic injuries, examination and laboratory findings are usually normal in the acute phase. Symptoms may be seen late and may have fatal results. In the acute phase, the sensitivity of abdominal tomography (CT) is 85%, while it can be evaluated as normal when first taken. Minor injuries may show symptoms days later. Therefore, suspected patients should definitely be hospitalized and followed up. Complications include acute pancreatitis, pseudocyst formation, pancreatic enzyme leakage, and retroperitoneal abscess after autodigestion. We aimed to emphasize the importance of the subject with a case example.

A 10-year-old male patient was brought to the emergency room after falling off a bicycle. The patient's general condition was good and he was conscious. His blood pressure was 100/70 mmHg. Pulse: 104/min. Respiration: 16/min. Temperature: 36.7 C. Physical examination revealed tenderness in the epigastric region and ecchymosis of 2 cm in diameter. Laboratory results showed WBC: 8 x 10^3/µL, CRP: 26, Amylase: 497 U/L, Lipase: 958 U/L. Abdominal CT revealed locally high-density (hemorrhagic content) free fluid in the Morrison pouch and pelvic region, reaching a diameter of approximately 4 cm. A heterogeneous hypodense volumetric appearance was seen at the distal part of the pancreatic body and tail, and at this level, a hyperdense area of approximately 21x22 mm (mean 63 HU) with borders that could not be clearly distinguished from the pancreatic tissue, which was initially evaluated as a hematoma. An appearance compatible with pancreatic laceration was detected. The patient was admitted to the pediatric surgery ward with the diagnosis of pancreatic laceration.

Pancreatic injury should be considered in the differential diagnosis in abdominal traumas. It should not be forgotten that physical examination, amylase and lipase values may not be sufficient to diagnose the severity of acute trauma and that abdominal tomography should be evaluated in necessary cases.

References

Güllüpınar B, Karakaya P. (2012). Pancreatic Injury: Case Report. Tr J Emerg Med, 12(1):48-50
Publisher | Google Scholor
Karaman I, Karaman A, Aslan MK, Erdoğan D, Cavuşoğlu YH, Tütün O. (2009). A hidden danger of childhood trauma: bicycle handlebar injuries. Surg Today, 39:572-574.
Publisher | Google Scholor
Sayan A, Karaçay Ş. (2007). Childhood bicycle traumas. Pediatric Surgery Journal, 21(2):86-92.
Publisher | Google Scholor
Mancel B, Alsam A. (2003). Traumatic abdominal wall hernia an unusual bicycle handlebar injury. Ped Surg Int, 19:746.
Publisher | Google Scholor

Delia Teresa Sponza

"Journal of BioMed Research and Reports has created a diverse portfolio in peer review process and provides a wide range scientific and medical novel papers to the scientists. This journal publishes high-quality, peer-reviewed content across all levels of professional development and corporate research and development."

Fatema Tashrifwala

I would like to thank the editorial team for their timely responses and consideration in the publication of my paper. They have been very helpful and accommodating, Lastly, being an open access journal, the published work is freely available and accessible to readers at no cost to them. I would encourage other authors to publish their research in BioRes Scientia. I am happy to be a part of BioRes Scientia Publishers.

Dr Nikhil Vitthal Dayama

I would like to thank the editorial team for their timely and prompt responses and consideration in the publication of my case report. Being an open access journal, it will be great help for the readers to learn the new things without any cost. I would encourage the authors to publish their research in BioRes Scientia and I am happy to be part of this journal.

Boubacar Ahy Diatta

I warmly thank the editorial team for the excellent work they do for continuing medical education in Dermatology. I was able to discover with joy their professionalist, their support and above all appreciate their social generosity on the access to the magazines which is free. This allows an update of scientific knowledge to the entire scientific community. I gladly recommend authors for publication in this journal.

Professor Rajko Igic

The editor of JBRR helped me during the whole process, mainly to eliminate some typographical and other errors. It hastened this publication to be published quickly. Although it is a short text, I believe that the content is important for all medical and other scientific disciplines because eventual addition of the iC citations to citation of the paper would lead to proper assessment of the author's contribution.

Dr Tewodros kassahun Tarekegn

I am thrilled to have had the opportunity to publish my research article in this prestigious journal. The entire process of peer review and publication support provided by the editorial office was exceptional, and it fortified my belief in the quality of my research study. The rigorous peer review process ensured that only the highest quality research was published, and the feedback from the reviewers was extremely helpful. I appreciate the journal's commitment to open access publication, enabling my research to reach a wider audience. The easy-to-use online platform streamlined the submission, peer review, and publication process, and I would confidently recommend this journal to any author looking for efficient, rigorous, and high-quality peer-reviewed publication.

Francis Okello Ooko

I was impressed by your author-centred approach whereby you maintained constant and timely communication with us from the time we submitted the manuscript to acceptance, each time providing critical suggestions to improve the manuscript. In addition, we are encouraged by the thoroughness of your editorial team in checking the originality and overall, quality of the work. Which I believe is very encouraging to other researchers and authors who wish to publish their work in your journals. The published work and the information imparted is freely available and accessible to a wide spectrum of readers at no cost to them. I would encourage other authors to publish their research in BioRes Scientia. I am happy to be a part of BioRes Scientia Publishers.

Dr Nidhi Sapolia

I would like to thank the editorial team of their timely response and guidance in the publication of my case report. They have been extremely helpful at all stages. Being an open access journal, it is of great help for the readers to learn new experiences in different fields, I would highly recommend this journal to authors for high quality peer-reviewed publications.

Dwight L Mckee MD CNS ABIHM

I am very impressed by the high quality of the papers published by the International Journal of Clinical and Molecular Oncology. The editors of this journal are a pleasure to work with, as they are highly responsive even to numerous last minute changes in the manuscript that I recently published with them, and the changes are made on-line the same day they are received. I highly recommend this journal to anyone working in the oncology field, and also value it as a source of cutting edge information in the field.

Kyaw Swar Thet

I would like to thank the editorial team for the opportunity to publish our case report in this prestigious journal. I am very impressed by their timely and efficient handling of the submission, peer review, and publication processes. As residents of a developing, low-income country, we greatly appreciate the discount on submission charges. I hope that as an open access journal, it will facilitate easy access for readers to update their scientific knowledge. I highly recommend this journal for high-quality, peer-reviewed publications. I express my sincere gratitude to the editorial team for their excellent work.

Michel Farah

I would like to thank the editorial team for their quick response and support. The publication support and editorial office were excellent and very helpful. I am happy to have my research article published in this prestigious journal. Our previous case report published in this journal was very successful and viewed by many physicians worldwide.