Emergency Whipple procedure for traumatic pancreas–duodenum separation in a patient with multiorgan injury: a case report and review

Although pancreaticoduodenal injuries are rare, they represent complex surgical conditions associated with high risks of morbidity and mortality. This case report presents an emergency pancreaticoduodenectomy (Whipple procedure) performed on a 17-year-old male patient who was admitted to the emergency department following a non-vehicular traffic accident. Imaging studies revealed free intraperitoneal air and fluid, as well as multiorgan injury, including right renal perfusion loss. Emergency surgical exploration revealed a Grade V pancreatic head avulsion, distal bile duct injury, duodenal laceration, a laceration in the proximal one-third of the transverse colon, and right renal devascularization. Considering the patient's intraoperative hemodynamic stability, a Whipple procedure, segmental colectomy with primary anastomosis, and right nephrectomy were performed. On postoperative day 11, a leak developed at the colocolonic anastomosis site, and the patient underwent emergency surgery involving a right hemicolectomy and end ileostomy. During the follow-up period, no additional emergency surgical intervention was required from a general surgery perspective. This case highlights the importance of multidisciplinary team collaboration and individualized surgical decision-making in the management of high-risk trauma based on the patient's clinical condition. In the presence of complex anatomical injuries, determining appropriate surgical timing, selecting optimal techniques, and managing complications play decisive roles in treatment success. In this context, the surgical approach and timing are discussed in light of the current literature and evaluated in comparison with similar cases.