Patient Aarti Bhagat, 17 years old, was referred to Endoscopy Asia with severe abdominal pain and vomiting. Patient’s past history revealed of multiple hospitalizations due to recurrent attacks of severe abdominal pain since 5 years. After undergoing several imaging modalities like CT scan abdomen, Ultrasonography and MRI, no accurate diagnosis could be reached nor could any treatment procedure be outlined.
Endoscopy Asia’s Intervention:
- Diagnosis: Endoscopy Asia considered opting for Endoscopic Ultrasound (EUS) as the best method to evaluate the pancreato-biliary system. EUS revealed large soft stones in the dilated pancreatic duct (14 mm) which was the cause of recurrent acute-on-chronic pancreatitis. Finally, an accurate diagnosis was arrived for patient’s symptoms. Patient was diagnosed with Advanced chronic calculus pancreatitis (Stone in the pancreas leading to Inflammation of pancreas).
- Treatment: Endoscopy Asia decided to perform ERCP (Endoscopic Retrograde Cholangio Pancreatography) whereby all the stones were cleared from the pancreatic duct.
- Prognosis of the patient: Post procedure patient did not complain of pain, vomiting or any other symptoms and no further attacks of pancreatitis were observed.
EUS performed at Endoscopy Asia can provide high-resolution images of both the ductal structures and parenchyma of the pancreas. Therefore it has the maximum sensitivity and specificity for the diagnosis of pancreatic diseases. Treatment of pancreatitis and pancreatic stone disease provided at Endoscopy Asia provides adequate relief from the symptoms without any invasive surgical intervention. Recent studies have also shown that pancreatic exocrine function can improve after the endoscopic treatment.
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Eus Picture Showing Dilated Pancreatic Duct With Stones Within
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Pancreatogram Showing Filling Defects In Main Pancreatic Duct Suggestive Of Stones
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Pancreatic Duct Clearance Revealing Soft Stones
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Pancreatic Duct Stenting Showing Free Flow Of Pancreatic Juice
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