Korean Journal of Gastrointestinal Endoscopy 2010;40(2): 139-143.
약제 유발성 췌장염으로 치료 중 재발 환자에서 발견된 Santorinicele을 동반한 분할 췌의 내시경적 치료 1예
심윤숙ㆍ이태훈ㆍ최준호ㆍ김상필ㆍ이세환ㆍ정일권ㆍ박상흠ㆍ김선주
순천향대학교 의과대학 천안병원 내과학교실
A Case of Successful Endoscopic Treatment for Acute Recurrent Pancreatitis Due to Pancreas Divisum with Santorinicele Masquerading as Drug Induced Pancreatitis
Yun Suk Shim, M.D., Tae Hoon Lee, M.D., Jun Ho Choi, M.D., Sang Pil Kim, M.D., Sae Hwan Lee, M.D., Il Kwun Chung, M.D., Sang Heum Park, M.D. and Sun Joo Kim, M.D.
Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
Abstract
There are various causes of acute pancreatitis, and accurately determining the etiology is pivotal for selecting appropriate management. Other hidden causes, such as congenital anomaly, should be considered in patients with recurrent abdominal pain or unexplained recurrent pancreatitis. A santorinicele is a focal cystic dilatation of the terminal dorsal pancreatic duct, and this is usually associated with pancreas divisum and it is a risk factor for acute pancreatitis due to the accompanying relative stenosis of the minor papilla. We present here the case of a patient who was treated for acute pancreatitis that was presumably was caused by either Rifampin or Brucellosis, and the patient recovered with conservative management. However, we eventually diagnosed pancreas divisum with santorinicele by performing MRCP and ERCP after the pancreatitis had relapsed. We report here on a case of successful endoscopic treatment for pancreas divisum with santorinicele as a cause of recurrent pancreatitis, and this was initially confused with drug or infection related pancreatitis. (Korean J Gastrointest Endosc 2009; 40:139-143)
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