An impacted minor papilla stone in a patient with pancreas divisum that caused acute exacerbation of chronic pancreatitis: a case report

• Published in: Nippon Shōkakibyō Gakkai zasshi Vol. 113; no. 11; p. 1916
• Main Authors: Isono, Yoshiaki, Matsusaki, Shimpei, Tanaka, Hiroki, Tochio, Tomomasa, Kumazawa, Hiroaki, Sase, Tomohiro, Saito, Tomonori, Okano, Hiroshi, Baba, Youichirou, Mukai, Katsumi
• Format: Journal Article
• Language: Japanese
• Published: Japan 2016
• Subjects: Acute Disease; Aged; Calcinosis - complications; Calcinosis - diagnostic imaging; Calcinosis - therapy; Cholangiopancreatography, Endoscopic Retrograde; Disease Progression; Duodenal Diseases - complications; Duodenal Diseases - diagnostic imaging; Duodenal Diseases - therapy; Female; Humans; Pancreatitis, Chronic - complications; Pancreatitis, Chronic - diagnostic imaging; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0446-6586
• DOI: 10.11405/nisshoshi.113.1916

A 75-year-old woman with epigastric pain was admitted to our emergency department. She was diagnosed with an acute exacerbation of chronic pancreatitis based on the results of blood tests and abdominal computed tomography (CT). The abdominal CT and magnetic resonance cholangiopancreatography revealed pancreas divisum. Abdominal CT also showed a stone in the minor papilla, with impaction of the stone being the most likely cause of the acute episode. Therefore, endoscopic sphincterotomy of the minor papilla and endoscopic naso-pancreatic duct drainage were performed to remove the stone and decrease the internal pressure of the pancreatic duct. These procedures improved the patient's clinical status. The naso-pancreatic drainage tube was removed, and her pancreatitis has not recurred. Herein, we report a rare case of an impacted minor papilla stone in a patient with pancreas divisum that caused an acute exacerbation of chronic pancreatitis.