# Iatrogenic injury

Iatrogenic injury

This can occur in several ways: /uni25CF Injury to the tail of  the pancreas during splenectomy , resulting in a pancreatic fistula. /uni25CF Injury to the pancreatic head and the accessory pancreatic duct (Santorini), which is the main duct in 7% of  patients, during Billroth II gastrectomy . A pancreatogram per formed by cannulating the duct at the time of  discovery of such an injury will demonstrate whether it is safe to ligate and divide the duct. If  no alternative drainage duct can be demonstrated, then the duct should be reanastomosed to the duodenum or alternatively r esection of  the pancreatic head should be considered. /uni25CF Enucleation of  islet cell tumours of  the pancreas can result in fistulae. /uni25CF Duodenal or ampullary bleeding following sphincteroto my . This injury may require duodenotomy to control the bleeding.