[Endoscopic treatment of a pediatric patient with acute pancreatitis caused by anomalous union of pancreaticobiliary duct combined with incomplete pancreatic divisum].
The most common causes of acute pancreatitis are microlithiasis and alcohol. In pediatrics, anomalies in pancreaticobiliary system should be considered as possible causes. Among many anomalies, pancreas divisum associated with anomalous pancreaticobiliary ductal union (APBDU) is very rare. APBDU is associated with acute pancreatitis, choledochal cyst, and gallbladder cancer. Pancreas divisum is also a well known cause of acute recurrent pancreatitis. In adult cases with such conditions, the role of endoscopic management including sphincterotomy or stenting through the Santorini duct is well documented. However, it is still controversial to perform endoscopic retrograde cholangiopancreatography in pediatrics. Herein, we experienced a case of 4 year 7 month old female patient suffered from recurrent attacks of acute pancreatitis, which were caused by APBDU and incomplete pancreas divisum. She was treated by endoscopic sphincterectomy of both openings to the Santorinis and Wirsungs ducts. Thus, we report this interesting case with literature review.
Park
Jun Beom
JB
Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Seo
Joo Hee
JH
Park
Jung Yeup
JY
Park
Seung Woo
SW
Song
Si Young
SY
Chung
Jae Bock
JB
Bang
Seungmin
S
D000015:Abnormalities, Multiple; D000208:Acute Disease; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003135:Common Bile Duct / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006801:Humans; D010179:Pancreas / Q000002:abnormalities*; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016717:Sphincterotomy, Endoscopic; D014057:Tomography, X-Ray Computed