A 24-year-old woman involved in a fall from height has CT showing a hypodense linear defect through the body of the pancreas with fluid separating the pancreas from the splenic vein. Which associated finding best supports complete pancreatic transection requiring surgical consultation?
- A Peripancreatic fat stranding alone
- B Fluid between the splenic artery and pancreas ✓
- C Thickening of Gerota's fascia
- D Duodenal wall thickening
Correct answer: B. Fluid between the splenic artery and pancreas
Explanation
Fluid interposed between the pancreas and the splenic artery or splenic vein is the most reliable CT sign of significant pancreatic duct injury, since the duct runs close to these vessels. Peripancreatic stranding and fascial thickening occur with simple pancreatic contusion. Duodenal thickening suggests duodenal injury but does not confirm duct disruption. Duct injury dictates management, whether operative or endoscopic stenting.
Reference: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.