Juvenile idiopathic fibrosing pancreatitis.
Chronic pancreatitis is a rare differential diagnosis of obstructive jaundice and/or recurrent abdominal pain in childhood and adolescence. The hereditary calcifying and the noncalcifying obstructive form are the two major forms of juvenile chronic pancreatitis. Other causes include cystic fibrosis, hyperparathyroidism, hyperlipoproteinemia and ascariasis. Even less common is the so called idiopathic or fibrosing pancreatitis. Since the first description by Comfort in 1946 only 41 further cases of juvenile idiopathic fibrosing pancreatitis have been published. An association with gene mutations (PRSS1, SPINK1, CTFR-5T genotype) is suspected. We report the cases of a 17-year-old male patient who presented with painless obstructive jaundice and a 16-year-old female patient who presented with abdominal pain and obstructive jaundice. Both patients underwent surgical treatment with duodenum-preserving pancreatic head resection. The relevant literature with special regard to modern pancreatic surgery is reviewed to give an overview about this rare but surgically treatable pediatric condition, which merits the attention of pediatricians and gastroenterologists in cases of children and adolescents suffering from unexplained abdominal pain.
Sclabas
Guido
G
Department of Visceral and Transplantation Surgery, University of Berne, Switzerland.
Kirschstein
Timo
T
Uhl
Waldemar
W
Hürlimann
Rainer
R
Ruchti
Charles
C
Büchler
Markus W
MW
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002779:Cholestasis / Q000209:etiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010180:Pancreatectomy; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D012008:Recurrence