Mechanism | Handlebar. | Fall on rocks. | Handlebar. | Handlebar. | Handlebar. |
Injuries | Pancreatic tail laceration and grade III splenic injury. | Pancreatic body transection | Pancreatic body transection and grade I liver injury. | Pancreatic body transection and grade III liver injury. | Pancreatic tail transection. |
Interim diet | PN and bland diet until pain and emesis developed, then kept NPO on PN until after procedure. | Failed NJ feedings, then kept NPO on PN until after procedure. | Kept NPO on PN until after procedure. | Regular diet until anorexia and ascites developed, then kept NPO on PN until after procedure. | Failed NJ feedings, then kept NPO on PN until after procedure. |
Other procedures | None. | None. | ERCP sphincterotomy. | Pancreatic duct stent. Percutaneous peritoneal drainage. | None. |
Time to cyst gastrostomy from initial injury | 6 weeks | 7 weeks | 5 weeks | 6 weeks | 5 weeks |
Pancreatic pseudocyst maximum size | 8×14×9 cm | 9×6×13 cm | 7×3×4 cm | 4×3×7 cm | 6×8×12 cm |
Time from stent placement to removal | 11 weeks: one stent removed, one had passed spontaneously. | 11 weeks: both stents removed. | 18 weeks: both stents removed. | 5 weeks: stent removed. | 3 weeks: stent removed. |
Time to last imaging and results | U/S at 2 months: no pseudocyst. AXR at 4 months: stent in position. | U/S at 39 months: no pseudocyst. | MRI at 8 months: no pseudocyst. MRI at 18 months: atrophy of tail. | U/S at 3 and 9 months: no pseudocyst, mild dilation of pancreatic duct. | U/S at 3 months: no pseudocyst. |
Length of follow-up (months) | 4 | 72 | 24 | 11 | 4 |
Outcome | No pain and regular diet at 4 months. | No pain and regular diet at 3 months. | No pain and regular diet but increased stooling and bloating at 3 months, trial of pancreatic enzymes stopped after 1 month. Bloating and vague pain at 6 months. Increased stools at 18 months | No pain and regular diet at 3 months. | No pain and regular diet at 4 months. |
Pancreatic function from time of injury | Amylase normalized at 1.5 months, lipase remained slightly elevated at 4 months. | Amylase normalized at 3 months, lipase normalized at 5 months. Fecal elastase and Hgb A1c normal at 72 months | Amylase normalized at 3 months, lipase normalized at 5 months. Fecal elastase and Hgb A1c normal at 4 months and 18 months. | Amylase normalized at 2 months, lipase remained slightly elevated at 3 months. | Amylase normalized at 6 weeks, lipase remained slightly elevated at 6 weeks. |