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Duodenal duplication with accessory papilla causing recurrent pancreatitis in a child: a case report

José R Muñiz-Aragunde1, María S Correa-Rivas, Humberto Lugo-Vicente

  • 1School of Medicine, University of Puerto Rico, Medical Sciences Campus.

Puerto Rico Health Sciences Journal
|June 7, 2007
PubMed

Insights

A pediatric patient experienced recurrent pancreatitis due to a duodenal duplication cyst. Surgical removal of the cyst, which had an accessory pancreatic papilla, resolved the pancreatitis episodes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Surgical Pathology

Background:

  • Recurrent pancreatitis in adolescents can stem from various causes.
  • Choledochal cysts are congenital biliary abnormalities, but can present atypically.
  • Duodenal duplications are rare congenital anomalies of the gastrointestinal tract.

Observation:

  • A 16-year-old male presented with three episodes of pancreatitis over six months.
  • Preoperative imaging suggested a choledochal cyst in the second portion of the duodenum.
  • Surgical exploration and resection of the duodenal lesion were performed.

Findings:

  • Pathology confirmed the lesion as a duodenal duplication cyst.
  • An accessory pancreatic papilla was identified entering the cyst.
  • This anatomical abnormality was determined to be the cause of the patient's pancreatitis.

Implications:

  • Duodenal duplication cysts should be considered in the differential diagnosis of pediatric recurrent pancreatitis.
  • Anomalous pancreatic ductal anatomy, such as accessory papilla, can lead to pancreatitis.
  • Surgical management of duodenal duplication cysts can effectively resolve associated pancreatitis.

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