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No Stone Left Unturned: Pediatric Pancreatic Stones Presenting With Obstructive Jaundice

Jonathan M deVries1, Sarah Sidhu1, Kathryn M Kimsey1

  • 1Department of Pediatric Gastroenterology and Nutrition, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.

JPGN Reports
|May 11, 2023
PubMed

Insights

Pediatric pancreatic lithiasis, often linked to cystic fibrosis (CF), can present with pancreatitis. A 10-year-old girl with undiagnosed CF experienced successful treatment for pancreatic lithiasis and jaundice via ERCP.

Area of Science:

  • Gastroenterology and Hepatology
  • Pediatric Medicine
  • Genetics

Background:

  • Pancreatic lithiasis, or pancreatic duct calcifications, is uncommon in children but associated with chronic pancreatitis (CP).
  • Cystic Fibrosis (CF), caused by CF transmembrane conductance regulator (CFTR) gene mutations, is a significant contributor to pediatric CP and pancreatic lithiasis.
  • Mild CF cases may present initially with pancreatitis, delaying diagnosis and treatment.

Observation:

  • A 10-year-old female with previously undiagnosed and untreated CF presented with abdominal pain, vomiting, and obstructive jaundice.
  • The patient exhibited pancreatic lithiasis and biliary obstruction.

Findings:

  • The patient's pancreatic lithiasis and biliary obstruction were successfully managed.
  • Endoscopic retrograde cholangiopancreatography (ERCP) proved effective in treating the condition.

Implications:

  • Highlights the importance of considering CF in pediatric patients presenting with unexplained pancreatic lithiasis and pancreatitis.
  • Underscores the potential for pancreatitis to be the initial clinical manifestation of undiagnosed CF.
  • Demonstrates the efficacy of ERCP in managing pancreatic lithiasis and associated biliary obstruction in pediatric CF patients.

Keywords:
cystic fibrosisjaundicepancreatic stonespancreatitis

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