2019 Volume 55 Issue 7 Pages 1182-1186
The patient was an 18-year-old woman who underwent resection of an extrahepatic bile duct at the age of 2 under the diagnosis of congenital biliary dilatation. She presented with upper abdominal pain and nausea when she visited a clinic. Imaging findings showed intrahepatic cholelithiasis with dilatation of bilateral intrahepatic bile ducts. We performed double-balloon enteroscopy (DBE) to retrieve biliary stones through Roux-en Y anastomosis. During enteroscopy, she frequently complained about epigastralgia, and she was diagnosed as having severe acute pancreatitis induced by the procedure. She underwent conservative treatment with a satisfactory clinical course and was discharged 57 days after the onset. Several mechanisms such as mechanical strain on the pancreas and stimulation of papillae could be responsible for the post-DBE pancreatitis. Some reported that the duration of enteroscopy and the insertion depth of the scope could be related to pancreatitis. Although DBE is recognized as a minimally invasive method, it could carry a risk of pancreatitis. It is important to inform patients of this possible complication prior to performing DBE and to consider the duration of treatment.
