A 49-year-old male with chief complaint of abdominal fullness who was pointed out massive ascites by abdominal ultrasonography admitted our hospital for further examinations and treatment on October 9th, 1996.
Anemia in palpebral conjunctiva and severe abdominal bulging was pointed out at physical examination. Laboratory data revealed elevation on serum amylase (1,031IU/l) and elastase I (1,363ng/dl) and abdominal fluid was exdate which has elevation of amylase (16,260IU/l) . About 2 cm in diameter of calcification was detected in head of the pancreas and cystic lesion was also revealed in tail of the pancreas by computer tomography. Endoscopic retrograde cholangiopancreatography (ERCP) revealed calcification (22×12mm) in head of the main pancreatic duct and cystic lesion in tail of the pancreas.
This patient was transfered to another hospital and pancreatolithiasis was successfully treated by extracorporeal shockwave lithotripsy (20KV, 2000shoots, Dornie Co, HM3) . After ESWL treatment, ascites was decreasing day by day, and ERCP and CT revealed disappearing of calcification in head of the pancreas.
We reviewed literature about ESWL for pancreatolithiasis in Japan. Averaged 39% (75-13%) of pancreatolithiasis was perfectly treated by ESWL and remainning part was also partialy disappeared without major complications. We conclude that ESWL is less invasive treatment for pancreatolithiasis without major complications, alternative to surgery.
