Pancreatitis Associated With Prolonged Double-Balloon Enteroscopy in a Patient With Intrahepatic Cholelithiasis After Congenital Choledochal Cyst Excision

Iguchi Masafumi, Fumino Shigehisa, Sakai Kohei, Higashi Mayumi, Aoi Shigeyoshi, Furukawa Taizo, Tajiri Tatsuro

doi:10.11164/jjsps.55.7_1182

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Other Title

長時間のダブルバルーン小腸内視鏡により重症膵炎を発症した先天性胆道拡張症術後肝内結石症の1例
症例報告長時間のダブルバルーン小腸内視鏡により重症膵炎を発症した先天性胆道拡張症術後肝内結石症の1例
ショウレイホウコクチョウジカンノダブルバルーンショウチョウナイシキョウニヨリジュウショウスイエンオハッショウシタセンテンセイタンドウカクチョウショウジュツゴカンナイケッセキショウノ 1レイ

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<p>The patient was an 18-year-old woman who underwent resection of an extrahepatic bile duct at the age of 2 under the diagnosis of congenital biliary dilatation. She presented with upper abdominal pain and nausea when she visited a clinic. Imaging findings showed intrahepatic cholelithiasis with dilatation of bilateral intrahepatic bile ducts. We performed double-balloon enteroscopy (DBE) to retrieve biliary stones through Roux-en Y anastomosis. During enteroscopy, she frequently complained about epigastralgia, and she was diagnosed as having severe acute pancreatitis induced by the procedure. She underwent conservative treatment with a satisfactory clinical course and was discharged 57 days after the onset. Several mechanisms such as mechanical strain on the pancreas and stimulation of papillae could be responsible for the post-DBE pancreatitis. Some reported that the duration of enteroscopy and the insertion depth of the scope could be related to pancreatitis. Although DBE is recognized as a minimally invasive method, it could carry a risk of pancreatitis. It is important to inform patients of this possible complication prior to performing DBE and to consider the duration of treatment.</p>

Journal

Journal of the Japanese Society of Pediatric Surgeons

Journal of the Japanese Society of Pediatric Surgeons 55 (7), 1182-1186, 2019-12-20

The Japanese Society of Pediatric Surgeons

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