Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis
Background. Chronic pancreatitis is very rare in childhood and causes chronic/relapsing abdominal pain, frequent hospitalizations, malnutrition, growth retardation, and stone formation in the main duct. Although pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is commonly used in the...
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| Format: | Article |
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Hacettepe University Institute of Child Health
2020-08-01
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| Series: | The Turkish Journal of Pediatrics |
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| Online Access: | https://turkjpediatr.org/article/view/502 |
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| author | Özlem Boybeyi Türer Tutku Soyer Erkan Parlak Hatice Nursun Özcan Cenk Yücel Bilen Feridun Cahit Tanyel |
| author_facet | Özlem Boybeyi Türer Tutku Soyer Erkan Parlak Hatice Nursun Özcan Cenk Yücel Bilen Feridun Cahit Tanyel |
| author_sort | Özlem Boybeyi Türer |
| collection | DOAJ |
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Background. Chronic pancreatitis is very rare in childhood and causes chronic/relapsing abdominal pain, frequent hospitalizations, malnutrition, growth retardation, and stone formation in the main duct. Although pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is commonly used in the treatment of pancreatic stones (PS) in adults, the use in children is still controversial. An adolescent girl with multiple PS is presented to discuss the use of ESWL as a treatment alternative in children with PS.
Case. A 14-year-old girl was admitted with abdominal pain and elevated pancreatic enzyme levels. Abdominal US showed irregularity and rough echogenicity in pancreas revealing pancreatitis. Multiple stones were seen in main pancreatic duct on Magnetic resonance cholangiopancreatography (MRCP). Endoscopic retrograde cholangiopancreatography (ERCP) was performed and dilated pancreatic duct, thickened pancreatic secretion were detected. Endoscopic sphincterotomy was performed. Endoscopic removal of stones could not be achieved since the largest stone was 17x8 mm. Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) was performed using electromagnetic lithotripter under general anesthesia. Following ESWL, fragmentation of stones in the main duct was confirmed with ERCP. After 3 sessions of ESWL, no ESWL-related complication was observed. Pain relief was achieved. The patient is still under follow-up regarding endocrine and exocrine function of pancreas.
Conclusion. ESWL may be an effective and safe management option in pediatric PS which could not be removed by ERCP. The patients managed with ESWL should be followed-up for a long time regarding the endocrine and exocrine functions of the pancreas. As in management of adult pancreatitis, clinical guidelines are needed regarding the management of pediatric PS.
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| format | Article |
| id | doaj-art-19127b2d90854c2ea15377ef7e49e863 |
| institution | DOAJ |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-19127b2d90854c2ea15377ef7e49e8632025-08-20T03:01:14ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212020-08-0162410.24953/turkjped.2020.04.023Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitisÖzlem Boybeyi Türer0Tutku Soyer1Erkan Parlak2Hatice Nursun Özcan3Cenk Yücel Bilen4Feridun Cahit Tanyel5Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.Departments of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey.Departments of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.Departments of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey. Background. Chronic pancreatitis is very rare in childhood and causes chronic/relapsing abdominal pain, frequent hospitalizations, malnutrition, growth retardation, and stone formation in the main duct. Although pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is commonly used in the treatment of pancreatic stones (PS) in adults, the use in children is still controversial. An adolescent girl with multiple PS is presented to discuss the use of ESWL as a treatment alternative in children with PS. Case. A 14-year-old girl was admitted with abdominal pain and elevated pancreatic enzyme levels. Abdominal US showed irregularity and rough echogenicity in pancreas revealing pancreatitis. Multiple stones were seen in main pancreatic duct on Magnetic resonance cholangiopancreatography (MRCP). Endoscopic retrograde cholangiopancreatography (ERCP) was performed and dilated pancreatic duct, thickened pancreatic secretion were detected. Endoscopic sphincterotomy was performed. Endoscopic removal of stones could not be achieved since the largest stone was 17x8 mm. Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) was performed using electromagnetic lithotripter under general anesthesia. Following ESWL, fragmentation of stones in the main duct was confirmed with ERCP. After 3 sessions of ESWL, no ESWL-related complication was observed. Pain relief was achieved. The patient is still under follow-up regarding endocrine and exocrine function of pancreas. Conclusion. ESWL may be an effective and safe management option in pediatric PS which could not be removed by ERCP. The patients managed with ESWL should be followed-up for a long time regarding the endocrine and exocrine functions of the pancreas. As in management of adult pancreatitis, clinical guidelines are needed regarding the management of pediatric PS. https://turkjpediatr.org/article/view/502ESWLcalcific pancreatitischildrenchronic pancreatitispancreatic stone |
| spellingShingle | Özlem Boybeyi Türer Tutku Soyer Erkan Parlak Hatice Nursun Özcan Cenk Yücel Bilen Feridun Cahit Tanyel Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis The Turkish Journal of Pediatrics ESWL calcific pancreatitis children chronic pancreatitis pancreatic stone |
| title | Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis |
| title_full | Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis |
| title_fullStr | Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis |
| title_full_unstemmed | Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis |
| title_short | Extracorporeal shock wave lithotripsy in the management of a 14-year-old girl with chronic calcific pancreatitis |
| title_sort | extracorporeal shock wave lithotripsy in the management of a 14 year old girl with chronic calcific pancreatitis |
| topic | ESWL calcific pancreatitis children chronic pancreatitis pancreatic stone |
| url | https://turkjpediatr.org/article/view/502 |
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