A 16-year-old adolescent Sudanese boy was referred to our emergency department with a 5-day history of upper and left hypochondrial pain after blunt abdominal trauma to the epigastric region with a solid object. His pain was dull-aching in nature, localized to the epigastrium and left hypochondrial areas, aggravated and increased by movement and partially relieved by analgesia, but he had no fever, radiation, nausea, vomiting, or other associated symptoms. He had a clear medical and surgical background with a complete vaccination history. He is not allergic to any drugs or chronic medications. On examination, he was fully conscious, oriented, and aware of his surroundings, slightly pale but not jaundiced. His pulse rate was 120 beats per minute, and he was hypotensive with a blood pressure of 95/50 mmHg and slightly dehydrated. Abdominal examination revealed moderated epigastric and left hypochondrial tenderness with guarding but no rigidity, with hypoactive sluggish bowel sounds. No organomegaly masses were detected. The systemic review was clear, and no abnormality was detected. Blood investigations were requested, and hemoglobin (Hb) of 8.5 g/dl was revealed with normal white blood cell (WBC) count and platelets (PLTs). Urinalysis and blood electrolytes were normal. A CECT abdomen was performed before referral, and it showed lesser sac collection/hematoma with suspected grade III splenic injury and suspected pancreatic parenchymal injury; no other organ injury was detected. The absence of magnetic resonance cholangiopancreatography (MRCP)/endoscopic retrograde cholangiopancreatography (ERCP) facilities supported the decision for emergency laparotomy after adequate resuscitation as the patient’s pain scale increased since the injury to presentation and vital sign charts were suggestive of intraperitoneal bleed correlating with the provisional diagnosis of splenic injury grade III. An exploratory laparotomy through upper midline incision revealed a normal spleen with a clear, thick fluid collection in the lesser sac and contused pancreas with peripancreatic hematoma and anterosuperior distal pancreatic body laceration with major duct injury of (1 × 1.2 cm punched-out pancreatic parenchymal tissue) approximately, involving pancreatic parenchyma and duct with preservation of the posterior duct wall and communication with the lesser sac collection and intact posterior parenchyma and pancreatic magna and splenic arteries confirming the diagnosis of grade III injury American Association for the Surgery of Trauma organ injury scale (AAST-OIS) intraoperatively. Lesser sac was accessed through the opening of the lesser omentum, careful examination of the pancreas, spleen, and major vascular structures. Peripancreatic wash, sample for amylase taken, debridement of the injury, and intraoperative discussion were made to drain the bed versus performing Roux-en-Y pancreatojejunostomy, and surgical reconstruction was the agreed option. Roux-en-Y pancreatojejunostomy reconstruction was made in a retro-colic position, a Roux limb of 50 cm length and 8 mm enterotomy in the antimesenteric border, side to side, single layer with a full-thickness pancreatic–jejunal (duct to mucosa) anastomosis using 4/0 polydioxanone (PDS) interrupted stitches between the jejunum and pancreatic duct and parenchyma with augmenting corner stitches. Jejunojejunostomy was reconstructed with a 40 cm jejunal limb from the ligament of Treitz applying a hand-sewn, two-layer technique with 3/0 vicryl sutures, pancreatic bed and peritoneal drainage in situ, and standard abdominal mass closure. Peritoneal fluid amylase tested positive, and oral intake started on day 3 postoperation. Drainage became dry on day 6 postoperation, and the patient was discharged home on day 10 with regular oral intake and diet. A follow-up for 6 months continued by phone, and it was uneventful; he went back to his work as a shepherd after 3 months and gained significant weight.