SUPPURATIVE PANCREATIC DUCTITIS IN A PATIENT WITH PANCREATIC DUCTAL CARCINOMA : A CASE REPORT

Abstract

A 71-year-old man was diagnosed with pancreatic carcinoma from the pancreatic head to the pancreatic body by endoscopic ultrasonography fine-needle aspiration. Since he was found to have duodenal stenosis, he underwent duodenal (bulbus) stenting. While he was receiving chemotherapy with gemcitabine, he complained of high-grade fever. Laboratory results showed a markedly elevated serum C-reactive protein level. Abdominal CT showed dilatation of a pancreatic branch duct and a high density of fat tissue around the pancreas.
We performed endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic pancreatic duct drainage. Purulent pancreatic fluid was drained endoscopically by a 5Fr plastic stent in the main duct, resulting in marked improvement of clinical symptoms. After stenting, his high-grade fever alleviated and his CRP level decreased.