ESWL as an Alternative Management of Pancreatic Lithiasis – Case Report

Wajszczuk E1*, Jurkiewicz B1, Kwaśniewicz P1, Samotyjek J1 and Dądalski M2

1Department of Pediatric Surgery and Pediatric Urology, Medical Postgraduate Education Center, Poland
2Department of Gastroenterology, Hepatology, Eating Disorders, Pediatrics Children's Memorial Health Institute, Poland

^*Correspondance to: Ewa Wajszczuk 

 PDF  Full Text DOI: 10.25107/2474-1647.3647

Abstract

Introduction: Pancreatic lithiasis is a condition rarely seen in the pediatric population, most often in patients suffering from chronic pancreatitis. Small deposits, that cause obstruction, are treated with endoscopy (endoscopic retrograde pancreatography with sphincterotomy and stenting). The larger deposits, however, must be treated otherwise. For patients with anatomical anomalies, surgery must be performed. Patients already operated on or with no coexisting anomalies may benefit from less invasive treatment. ESWL (Extracorporeal Shock Wave Lithotripsy) is a method dedicated to treat urolithiasis, but since 1989 it is used for the management of pancreatic stones in the adult population with good effects. Objective: The aim of this paper is to present a case report of a 13-year-old patient with pancreatic lithiasis on the basis of genetic mutation and chronic pancreatitis, treated with a combination of endoscopic procedures followed by ESWL of the pancreas. Materials and Methods: After a proper imagining, ERCP followed by ESWL were performed. Under general anesthesia, the patient was placed in a supine position with the right side raised by about 15 degrees. Using the power of 10% to 40%, the frequency of 1 Hz, and 1,500 pulses, a very good disintegration of the deposits was obtained. No complications were observed. Conclusion: ESWL with combination of endoscopic procedures is an effective and small invasive way of treating pancreatic stones and may be used in children.

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Cite the article

Wajszczuk E, Jurkiewicz B, Kwaśniewicz P, Samotyjek J, Dądalski M. ESWL as an Alternative Management of Pancreatic Lithiasis – Case Report. Clin Surg. 2023; 8: 3647..