A Case of Recurrent Pancreatitis Associated With Pancreas Divisum and a Mutation of the Pancreatic Secretory Trypsin Inhibitor, Kazal Type 1 (SPINK1) Gene

Abstract

We herein report the case of a 13-year-old girl with recurrent pancreatitis caused by pancreas divisum and a mutation of the pancreatic secretory trypsin inhibitor, karal type 1 (SPINK1) gene. At age 9, she presented with abdominal pain and vomiting accompanied by plasma amylase level elevation after a back contusion. She was diagnosed as having blunt pancreas trauma and treated conservatively. At age 11, her symptoms recurred, and endoscopic retrograde cholangiopancreatography (ERCP) revealed a complete pancreas divisum. As endoscopic minor papillotomy and endoscopic stenting of the dorsal pancreatic duct had not resolved her symptoms, a genetic analysis was performed to determine the cause of recurrent pancreatitis. She was diagnosed as having hereditary pancreatitis with a mutation of the SPINK1 gene. When patients with pancreas divisum present with recurrent pancreatitis, a genetic analysis for potential hereditary pancreatitis should be carried out before performing surgical treatment. Surgical treatment should be restricted to patients with dorsal pancreatitis.