Pancreatic trauma represents an uncommon case of injuries following blunt abdominal trauma. Isolated trauma is rare and most of the time it is associated with injuries to other organs. Traumatic pancreatic injuries are characterized by high morbidity and mortality. The diagnosis of pancreatic trauma is still challenging today. Signs and symptoms can be non-specific or even absent, and radiological imaging may not always be clear in defining its severity. The management of pancreatic trauma depends on several factors, the most important being the hemodynamic status of the patient and the involvement of the main duct. We present the case of a young woman admitted to the Regional Level 1 Trauma Center after a low-kinetic bike ride accident. The patient was hemodynamically normal at hospital admission, presenting only with abdominal pain. A CT scan of the abdomen was performed, identifying an isolated AAST grade III lesion of the pancreas with complete section of the Wirsung Duct. Despite limited data in the literature, an ERCP was performed and a Wirsung prosthesis was placed. The patient was discharged early, one week after admission, in good general condition.
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