A YOUNG BOY WITH RECURRENT PANCREATITIS

Dr. Parshi Bhavana*, Dr. Abhishek, Dr. K. Ravinder Reddy, Dr. B. Sashidhar Reddy, Dr. K. Alekhya M. D.

ABSTRACT

Background: Anomalous Pancreaticobiliary Ductal Union (APBDU) is a rare congenital anomaly characterised by the union of the pancreatic and bile ducts outside the duodenal wall, resulting in a long common channel and loss of sphincter of Oddi influence. This leads to mutual reflux of pancreatic and biliary secretions, causing recurrent pancreatitis and predisposing to biliary malignancies. Case Presentation: We report an 11-year-old boy presenting with recurrent abdominal pain over 2 years, with the current episode associated with fever and jaundice. Laboratory investigations revealed markedly elevated serum lipase, amylase, bilirubin, ALP, and GGT. MRCP demonstrated a bulky pancreas with dilated CBD and distal CBD calculi. Therapeutic ERCP confirmed a Type I Choledochal cyst with APBDU — a long common channel between the biliary and pancreatic ducts. CBD stenting provided symptom relief and the patient was planned for surgical management.

Keywords: Anomalous Pancreaticobiliary Ductal Union; APBDU; Recurrent Acute Pancreatitis; Choledochal Cyst; ERCP; Pediatric Pancreatitis; Biliary Malignancy.