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Recurrent acute pancreatitis in bowel malrotation.
G Alessandri1, A Amodio, L Landoni
1HPB Unit, Department of Surgery, Manchester Royal Infirmary Hospital, Central Manchester Foundation Trust, Manchester, UK. alessandrigiorgio@hotmail.it.
European Review for Medical and Pharmacological Sciences
|December 2, 2016
Summary
Recurrent acute pancreatitis in teenagers may signal midgut malrotation, a condition often diagnosed late. Surgical correction, like Ladd's procedure, is effective, while endoscopic methods offer no added benefit.
Area of Science:
- Gastroenterology
- Pediatric Surgery
Background:
- Recurrent acute pancreatitis is rare in adolescents, with genetic factors, duct abnormalities, and congenital duodenal issues being common causes.
- Midgut malrotation is an infrequent but significant etiology for recurrent pancreatitis in this age group, often presenting with diagnostic delays.
Observation:
- This report details a case of recurrent pancreatitis in a young adult with a delayed diagnosis of midgut malrotation.
- An endoscopic management approach was attempted, alongside a literature review and analysis of two prior cases.
Findings:
- The patient remained asymptomatic after 24 months of follow-up, maintaining a free diet with normal pancreatic enzyme levels.
- No recurrence of acute pancreatitis was observed post-intervention.
Implications:
- Atypical recurrent acute pancreatitis in young adults, excluding alcohol and gallstones, warrants consideration of midgut malrotation in the differential diagnosis.
- Ladd's procedure is the recommended surgical treatment for symptomatic malrotation, proving more beneficial than endoscopic interventions in this context.
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