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[Pancreas duct stenosis of unknown origin]
1Medizinische Klinik C, Klinikum Ludwigshafen gGmbH, Germany. schorrf@klilu.de
History:
A 38-year old man presented himself for further clarification of a previously discovered circumscribed stenosis of the pancreatic duct. He had experienced several episodes of pancreatitis characterized by abdominal pain and increased lipase values.
Investigation:
The endoscopic retrograde cholangiopancreatography demonstrated a "double duct" sign with corresponding stenosis of the bile and pancreatic ducts. No space-occupying mass was identified. There was no evidence of chronic pancreatitis.
Diagnosis, Treatment And Course:
Post-inflammatory stenosis of the pancreatic duct was suspected. As the patient requested definitive diagnosis Whipple's operation was performed. It confirmed that the changes were benign. Histologic examination revealed changes of an autoimmune pancreatitis.
Conclusion:
Circumscribed changes in the pancreatic duct, especially in young patients, should be clarified with all modern invasive and noninvasive modes of investigation to exclude with certainty a malignancy and avoid unnecessary resection.
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Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
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