Blunt Pancreatic Transection With Ductal Disruption in a Stable Patient: Rethinking Surgical Necessity Through a Case‐Based Review

Blunt pancreatic trauma is uncommon and difficult to diagnose early due to its retroperitoneal location and vague symptoms. While high‐grade injuries with ductal disruption often require surgery, selected hemodynamically stable cases may benefit from conservative management. We describe a 20‐year‐old woman who sustained a Grade III pancreatic transection with suspected ductal injury following blunt abdominal trauma from a horse kick. Despite a delayed diagnosis, she remained stable. Imaging with MRI and contrast‐enhanced CT confirmed complete distal pancreatic transection and a nonbleeding splenic contusion. A multidisciplinary team opted for nonoperative management, including antibiotics, bowel rest, parenteral nutrition, and close monitoring. The patient recovered without complications or need for surgery. Follow‐up imaging confirmed resolution without pseudocyst or abscess formation. This case supports the safety and effectiveness of conservative management in select high‐grade pancreatic injuries with ductal disruption, emphasizing the importance of early imaging, multidisciplinary coordination, and tailored decision‐making, especially in resource‐limited settings.