Brief:
6 yrs male child with Acute on Chronic Pancreatitis in the setting of Pancreato-Biliary Ductal anomaly

Description:

• 06/M child came with a severe pain in abdomen for the last few days
• EUS revealed a dilated fusiform intra pancreatic portion of the CBD and MPD with large soft stones leading to dilated CBD and MPD with changes of chronic pancreatitis
• ERCP was considered - Selective cannulation of MPD was achieved and pancreatogram confirmed EUS findings
• All the soft stones were cleared from the MPD and a 5 fr single pigtail stent was placed into the MPD
• In view of abnormal LFT a 7 fr stent was then placed in the CBD, patient’s symptoms subsided immediately after the procedure

TAKE HOME MESSAGE

• Irrespective of the age of the patient even in children, EUS-ERCP interface allowed us to provide accurate diagnosis and optimum immediate treatment. Patient will require a definitive surgical intervention once Cholangitis and Pancreatitis subsides

Image:

1.EUS showing dilated MPD with large soft stones

2.Selective cannulation of MPD was achieved

3.Pancreatogram showed fusiform dilatation with soft stones

4.All the soft stones were cleared from the MPD

5.cholangiogram showed ductal anomaly

6.5fr single pigtail stent placed in the MPD and 7fr stent was placed in the CBD