2019 Volume 55 Issue 2 Pages 269-273
A 12-year-old boy was referred to our hospital with the complaint of jaundice. Abdominal computed tomography (CT) and magnetic resonance imaging revealed a mass lesion measuring about 6 cm in diameter in the head of the pancreas. Enhanced CT revealed a gradual contrast enhancement of both the capsule and the solid components of the lesion, leading to a diagnosis of solid-pseudopapillary neoplasm (SPN) of the pancreas. Pylorus-preserving pancreatoduodenectomy (PD) was performed with reconstruction of the digestive tract by the modified Child method using the modified Blumgart anastomosis. The histopathological diagnosis was SPN without malignant potential, and the surgical margin was negative for malignant cells. His postoperative course was uneventful and no metastasis or local recurrence was found 18 months after the surgery. Although SPN is rare in male and rarely causes jaundice, precise imaging studies made it possible to make a preoperative diagnosis of SPN. Moreover, the modified Blumgart anastomosis, which has already been recognized as a superior procedure to reduce the rate of postoperative pancreatic fistula formation in adults, is also effective as a method of pancreaticojejunostomy after PD in children.