Abstract

BACKGROUNDPancreatic injury occurs in 2% of blunt trauma cases. Although the mortality rate of pancreatic injury without main pancreatic duct (MPD) injury is ~7%, which of pancreatic injury with MPD injury is 29%.1,2 Because of the low prevalence of pancreatic injury, there have only been a few large clinical trials or cohort studies, resulting in a lack of established treatment strategies with sufficient evidence.With progress in endoscopic technology, non‐operative management for pancreatic injury has become increasingly common. It was mostly performed in stable patients with pancreatic injury with Organ Injury Scale (OIS) grades I, II, and III. In cases of pancreatic injury with OIS grade ≥IV, surgical management remains the gold standard.3CASE PRESENTATIONA 68‐year‐old male complaining of abdominal pain and diarrhea was admitted to a previous hospital and diagnosed with severe acute pancreatitis. He developed fever and oliguria 2 days later and was transferred to our hospital for intensive care. His vital signs on arrival were as follows: blood pressure, 158/99 mm Hg; pulse rate, 116/min; and oxygen saturation, 99% on a 1 L nasal cannula. There was no reported history of trauma; however, physical examination revealed bruising on the upper middle quadrant. An abdominal computed tomography (CT) scan showed total disruption