We present herein an 11-year-old boy with recurrent pancreatitis whose pancreatic duct was not visualized during two sessions of endoscopic retrograde cholangiopancreatography (ERCP). Operative pancreatography subsequently demonstrated a diffusely small pancreatic duct. Pancreatic duct hypoplasia, leading to recurrent pancreatitis, has not been reported previously, to our knowledge. The pathogenesis of recurrent pancreatitis and the surgical management of this pancreatic ductal anomaly are discussed.
Congenital anomalies of the pancreatic ductal system result from abnormalities of embryologic fusion of the ducts of the dorsal and ventral pancreatic primordia.1 These anomalies include the common channel syndrome, resulting from the anomalous insertion of the main pancreatic duct into the common bile duct, pancreas divisum, and congenital stricture of the main pancreatic duct.1,2
Patient Report. An 11-year-old white boy was referred to the Pediatric Gastroenterology Service at Hermann Children's Hospital and the University of Texas Medical School, Houston, for evaluation of recurrent epigastric