Severe post-traumatic Pancreatoduodenal injury with septic shock and enteric fistula: A multidisciplinary challenge - Case report.

Abstract

Severe pancreatoduodenal trauma presents complex management challenges with high morbidity and mortality. We report a case of 16-year-old male sustained severe pancreatoduodenal injuries following a high-velocity motorcycle collision, presenting with pancreatic contusion and partial duodenal transection. The postoperative course was complicated by septic shock, acute kidney injury, and subsequent development of a high-output duodenal fistula with multidrug-resistant infections. Through coordinated critical care, targeted antimicrobial therapy, and nutritional support, the patient demonstrated clinical improvement with resolution of major complications, ultimately achieving sufficient stability for ICU discharge. However, a significant functional impairment persisted requiring ongoing care. This case highlights the critical importance of prompt recognition of combined pancreatoduodenal injuries, staged surgical intervention, and multidisciplinary management in high-energy trauma.