抄録
A 65-year-old male patient was admitted to the hospital complaining of epigastralgia. He was suffering from chronic pancreatitis associated with alcoholism and had undergone partial pancreatectomy with pancreaticogastrostomy because of pancreatic tumor, for which cancer could not be ruled out; the operative specimen revealed tumor-forming pancreatitis. On admission, hematologic examination revealed no elevation of the pancreatic enzymes and a contrast-enhanced CT showed no evidence of active pancreatitis. Despite intravenous hydration and opiate administration, the patient continued to suffer from epigastric pain, therefore, we attempted endoscopic therapy. Upper GI endoscopy showed a small pancreatic duct opening with convergence of the folds on the posterior wall of the antrum, and stenting was performed through the anastomotic opening. Thereafter, the patient’s symptom disappeared and there has been no recurrence.
Endoscopic treatment for abdominal pain associated with chronic pancreatitis has been reported to yield high success rates of symptom relief without major complications, but also a high recurrence rate during follow-up. We describe an unusual case of endoscopic stenting performed through a pancreaticogastrostomy anastomosis. Owing to its low invasiveness, endoscopic therapy can be offered as first−line treatment in such cases, although careful follow-up is required.
