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Idiopathic fibrosing pancreatitis presenting with obstructive jaundice in a child
R Keil1, J Snajdauf, J Kalousová
1Department of Internal Medicine, 2nd Medical Faculty, Charles University of Prague, Prague, Czech Republic.
Insights
Idiopathic fibrosing pancreatitis (IFP) can cause obstructive jaundice in children. Endoscopic retrograde cholangiopancreatography (ERCP) with temporary stenting offers a safer, less invasive treatment for common bile duct (CBD) compression.
Area of Science:
- Pediatric Gastroenterology
- Hepatobiliary Surgery
- Interventional Endoscopy
Background:
- Idiopathic fibrosing pancreatitis (IFP) is a rare condition causing obstructive jaundice in children.
- The condition results from circumferential compression of the intrapancreatic common bile duct (CBD).
- Traditional treatments involve invasive biliodigestive surgical decompression.
Observation:
- A 14-year-old boy presented with obstructive jaundice due to IFP.
- Diagnosis was confirmed histologically after open surgery.
- The patient underwent successful temporary drainage of the compressed CBD via ERCP with stenting.
Findings:
- The endoscopic stenting successfully relieved CBD compression and jaundice.
- The patient experienced no pancreatic insufficiency at 3.5-year follow-up.
- Histological confirmation of IFP was obtained post-operatively.
Implications:
- Endoscopic retrograde cholangiopancreatography (ERCP) with temporary stenting is a viable, less invasive alternative to surgery for IFP.
- This approach offers a safer treatment option for pediatric obstructive jaundice caused by IFP.
- Further studies may explore long-term outcomes of endoscopic management for IFP.
Abstract:
Idiopathic fibrosing pancreatitis (IFP) is a rare cause of obstructive jaundice in children. The obstruction is caused by circumferential compression of the intrapancreatic portion of the common bile duct (CBD). Various forms of biliary decompression, including surgical sphincteroplasty, choledochoduodenostomy, and Roux-en-Y choledochojejunostomy are employed as a treatment. We report a 14-year-old boy with IFP who was successfully treated by a temporary drainage of compressed CBD with the help of a stent placed by endoscopic retrograde cholangiopancreatography (ERCP). The diagnosis of IFP was confirmed histologically after open surgery. The patient remains well after 3.5 years of follow-up with no evidence of pancreatic insufficiency. This report offers an additional case of IFP causing obstructive jaundice treated by temporary internal drainage of CBD, which is safer and less invasive than biliodigestive surgical decompression.