Abstract
A 62 years-old Caucasian male, who had a consumptive condition associated with recurrent episodes of abdominal pain, was evaluated in a Gastroenterology consultation. Physical examination was quite innocent and the following imaging exams were performed. A Computed Tomography (CT) showed a thin gallbladder and chronic pancreatitis signs with pancreatic intraductal stones, dominant at tail and body, associated with pancreatic tail atrophy. An abdominal-Magnetic Resonance Imaging (MRI) showed an abnormal pancreatic parenchyma, a mild Wirsung dilatation and an unknown pancreatic head stenosis etiology. Therefore, to clarify the pancreatic stenosis, an echo-endoscopy (EUS) was performed. This exam showed a 10-mmstone associated with a focal narrowing in the head/tail transition. A pancreatoscopy-guided holmium laser using a mini-endoscope inserted into the pancreatic duct successfully broke the impacted stone and cleared the obstruction, without complications. After that, endotherapy with plastic stents was repeatedly done, during the following 6 months. After endoscopic treatment, the patient recovered quite well, without any symptoms, without pancreatic stenosis and higher quality of life.
Highlights
BackgroundPancreatic duct stone formation is a chronic pancreatitis complication that causes recurrent episodes of pain and can be manage endoscopically
Pancreatic duct stone formation is a chronic pancreatitis complication that causes recurrent episodes of pain and can be manage endoscopically.Patients with difficult pancreatic duct stones can be treated with holmium laser, which is a safe and effective treatment
Case Presentation We report a case of a 62-year-old male with heavy alcohol consumption referred to a Gastroenterology Consultation with recurrent episodes of diffuse abdominal pain
Summary
Pancreatic duct stone formation is a chronic pancreatitis complication that causes recurrent episodes of pain and can be manage endoscopically. Patients with difficult pancreatic duct stones can be treated with holmium laser, which is a safe and effective treatment. It is a promising method for experienced gastroenterologists and may replace, in a near future external lithotripsy in the management of intraductal stones. Case Presentation We report a case of a 62-year-old male with heavy alcohol consumption referred to a Gastroenterology Consultation with recurrent episodes of diffuse abdominal pain He has medical history of chronic pancreatitis; type 2 Diabetes Mellitus with diabetic retinopathy and diabetic foot ulcer; hypertension and Charcot syndrome. Pancreatoscopy-guided holmium laser, using a mini-endoscope inserted into the pancreatic duct successfully broken the impacted stone and cleared the obstruction, without complications. Laser Mini endoscope inserted into the pancreatic duct successfully broken the impacted stone and cleared the obstruction
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