Endoscopic Diagnosis and Endotherapy of Calculous Chronic Pancreatitis - EUS-ENDOTHERAPY INTERFACE- In a 7 months pregnant female patient.
Brief:
Endoscopic diagnosis, staging and palliation of malignant gastric outlet obstruction
Description:
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A 30 yrs old 7 months pregnant female patient was referred to us for the favour of EUS to evaluate the exact etiology of recurrent episodes of acute pancreatitis since 2012 and patient has been treated with conservative medication.
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Patient has been in pain almost every day for the last few week requiring injectable analgesics and antispasmodic and hence after explaining all the risks of the procedure, EUS sos Endotherapy was considered once the relatives gave the informed consent.
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EUS showed A 7.0mm stone and few concrements were seen in the Prepapillary portion of the MPD
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MPD appeared dilated and irregular in the genu and body
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Selective cannulation of MPD, Pancreatogram confirmed the EUS findings, Pancreatic sphincterotomy was performed.
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Prepapillary Stones and concrements from the pancreatic duct was extracted with balloon catheter and complete ductal clearance was achieved.
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A 7 fr stent was then placed in the MPD
TAKE HOME MESSAGE
As we have seen in this case, a 7 months pregnant female developed recurrent acute on chronic calculous pancreatitis which was effectively diagnosed with EUS mapping of pancreas, and despite pregnancy a successful Endotherapy was performed safely for the patient and intrauterine foetus. EUS-Endotherapy Interface should be considered in all patients suffering from Recurrent Acute / Chronic Pancreatitis. In our experience of over few hundred cases we found the overall success rate of longterm symptom relief in about 70% patients.
Image:
1.A 7mm Stones and few concrements were seen in the prepapillary portion of the MPD.
2.MPD appeared dilated (8 mm) in the head region with soft stones
3.MPD appeared dilated and irregular in the genu and body
4.Selective cannulation of MPD
5.Pancreatogram confirmed the EUS findings
6.Pancreatic Sphincterotomy was performed
7.Prepapillary Stones and concrements from the pancreatic duct was extracted with balloon catheter
8.A 7 fr stent was then placed in the MPD
Posted by Dr. Vipulroy Rathod
Nov 10, 2016
Categories:
Gastrovision Case Capsules
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