Fig. 2

(a) Endoscopic retrograde pancreatography (ERP) findings, (b) CT findings after ERP, and (c) the findings during damage control surgery and views of the surgical site. Endoscopic retrograde pancreatography (ERP) findings in semi-prone position: Major leakage was found from the main pancreatic duct when contrast medium was injected from the ampulla of Vater (white arrowhead). Although the guidewire (black arrowhead) was able to be placed in the distal pancreatic duct, EPST and ENPD tube could not be cannulated to the distal duct over the injured sight. (b) Abdominal CT findings following ERP: abdominal CT revealing major leakage of contrast media and free air intraperitoneal and retroperitoneal space around the pancreas following ERP. (c) The findings during damage control surgery and views of the surgical site: a laceration with a diameter of approximately 2.5 cm and hemorrhage found on the cranial side of the pancreatic head by Kocher’s maneuver and entering omental bursa