Korean J Gastroenterol.  2009 Nov;54(5):333-336. 10.4166/kjg.2009.54.5.333.

Endoscopic Treatment of a Pediatric Patient with Acute Pancreatitis Caused by Anomalous Union of Pancreaticobiliary Duct Combined with Incomplete Pancreatic Divisum

• Park JB
• Seo JH
• Park JY
• Park SW
• Song SY
• Chung JB
• Bang S

• KMID: 1767742
• DOI: http://doi.org/10.4166/kjg.2009.54.5.333

Abstract

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 sphincteretomy of both openings to the Santorini's and Wirsung's ducts. Thus, we report this interesting case with literature review.

Keyword

Pancreas divisum; Anomalous pancreaticobiliary ductal union; Pediatrics; Acute pancreatitis

MeSH Terms

Abnormalities, Multiple
Acute Disease
Child, Preschool
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct/*abnormalities/surgery
Female
Humans
Pancreas/*abnormalities
Pancreatic Ducts/*abnormalities/surgery
Pancreatitis/*diagnosis/etiology/surgery
Sphincterotomy, Endoscopic
Tomography, X-Ray Computed