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Digestive Diseases and Sciences

, Volume 60, Issue 9, pp 2840–2843 | Cite as

Pancreatic Calculus Causing Biliary Obstruction: Endoscopic Therapy for a Rare Initial Presentation of Chronic Pancreatitis

  • Anurag J. Shetty
  • C. Ganesh Pai
  • Shiran Shetty
  • Girisha Balaraju
Case Report
  • 215 Downloads

Abstract

Introduction

Biliary obstruction in chronic calcific pancreatitis (CCP) is often caused by inflammatory or fibrotic strictures of the bile duct, carcinoma of head of pancreas or less commonly by compression from pseudocysts. Pancreatic calculi causing ampullary obstruction and leading to obstructive jaundice is extremely rare.

Methods

The medical records of all patients with CCP or biliary obstruction who underwent endoscopic retrograde cholangiopancreatography (ERCP) over 4 years between 2010–2014 at Kasturba Medical College, Manipal were analyzed.

Results

Five patients of CCP with impacted pancreatic calculi at the ampulla demonstrated during ERCP were identified. All 5 presented with biliary obstruction and were incidentally detected to have CCP when evaluated for the same; 3 patients had features of cholangitis. All the patients were managed successfully by endoscopic papillotomy and extraction of pancreatic calculi from the ampulla with resolution of biliary obstruction.

Conclusion

Pancreatic calculus causing ampullary obstruction, though very rare, should be considered as a possibility in patients with CCP complicated by biliary obstruction. Endoscopic therapy is affective in the resolution of biliary obstruction in such patients.

Keywords

Chronic pancreatitis Biliary obstruction Endoscopic therapy Pancreatic calculi 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Anurag J. Shetty
    • 1
  • C. Ganesh Pai
    • 1
  • Shiran Shetty
    • 1
  • Girisha Balaraju
    • 1
  1. 1.Department of Gastroenterology and Hepatology, Kasturba Medical CollegeManipal UniversityManipalIndia

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