Park Jun Beom, Seo Joo Hee, Park Jung Yeup, Park Seung Woo, Song Si Young, Chung Jae Bock, Bang Seungmin
Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2009 Nov;54(5):333-6. doi: 10.4166/kjg.2009.54.5.333.
The most common causes of acute pancreatitis are microlithiasis and alcohol. In pediatrics, anomalies in pancreaticobiliary system should be considered as possible causes. Among many anomalies, pancreas divisum associated with anomalous pancreaticobiliary ductal union (APBDU) is very rare. APBDU is associated with acute pancreatitis, choledochal cyst, and gallbladder cancer. Pancreas divisum is also a well known cause of acute recurrent pancreatitis. In adult cases with such conditions, the role of endoscopic management including sphincterotomy or stenting through the Santorini duct is well documented. However, it is still controversial to perform endoscopic retrograde cholangiopancreatography in pediatrics. Herein, we experienced a case of 4 year 7 month old female patient suffered from recurrent attacks of acute pancreatitis, which were caused by APBDU and incomplete pancreas divisum. She was treated by endoscopic sphincterectomy of both openings to the Santorinis and Wirsungs ducts. Thus, we report this interesting case with literature review.
急性胰腺炎最常见的病因是微结石症和酒精。在儿科中,胰胆管系统异常应被视为可能的病因。在众多异常情况中,胰腺分裂合并异常胰胆管汇合(APBDU)非常罕见。APBDU与急性胰腺炎、胆总管囊肿和胆囊癌相关。胰腺分裂也是急性复发性胰腺炎的一个众所周知的病因。在患有此类病症的成年病例中,包括通过Santorini管进行括约肌切开术或支架置入术在内的内镜治疗的作用已有充分记录。然而,在儿科中进行内镜逆行胰胆管造影术仍存在争议。在此,我们遇到一例4岁7个月大的女性患者,她反复出现急性胰腺炎发作,病因是APBDU和不完全性胰腺分裂。她接受了对Santorini管和Wirsung管两个开口的内镜括约肌切除术治疗。因此,我们结合文献回顾报告了这个有趣的病例。