J Korean Assoc Pediatr Surg.  2005 Dec;11(2):175-179.

Recurrent Pancreatitis Caused by Intraluminal Duodenal Diverticulum in an 11-year-old Girl: a Case Report

Affiliations
  • 1Department of Pediatric, School of Medicine, Kyungpook National University, Taegu, Korea. kpnugs@yahoo.co.kr
  • 2Department of Surgery, School of Medicine, Kyungpook National University, Taegu, Korea.

Abstract

An 11-year-old girl with history of two previous attacks of acute pancreatitis was admitted to another hospital. On physical examination, she had epigastric tenderness. Laboratory studies included amylase of 657IU/L and lipase of 3131IU/L. Abdominal computed tomography (CT) scan suggested necrosis in 30% of pancreas. To establish the cause of recurrent pancreatitis, endoscopic retrograde cholangiopancreatography (ERCP) was performed after acute pancreatitis subsided. Duodenoscopic view revealed a blind sac covered by normal duodenal mucosa at the second portion of the duodenum. Barium upper gastrointestinal series (UGI) showed a large sac separated from adjacent duodenal lumen by a radiolucent band. Diagnosis of intraluminal duodenal diverticulum (IDD) was made and endoscopic excision was considered. The apex of the diverticulum was incised endoscopically using a needle knife papillotome. At a follow-up endoscopy one day after procedure, bleeding from the incised edge of diverticulum was noted. Despite hemoclipping and injection of hypertonic saline-epinephrine solution by under the endoscopy, hemostasis was unsuccessful. She was transferred to the Kyungpook National University Hospital after resuscitation. Open duodenotomy and excision of the diverticulum were performed. She has recovered well from surgery and remains asymptomatic.

Keyword

Diverticulum; Duodenum; Intraluminal; Pancreatitis

MeSH Terms

Amylases
Barium
Child*
Cholangiopancreatography, Endoscopic Retrograde
Diagnosis
Diverticulum*
Duodenum
Endoscopy
Female*
Follow-Up Studies
Gyeongsangbuk-do
Hemorrhage
Hemostasis
Humans
Lipase
Mucous Membrane
Necrosis
Needles
Pancreas
Pancreatitis*
Physical Examination
Resuscitation
Amylases
Barium
Lipase
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