Giant solitary pancreatic stone in a chronic pancreatitis patient

Abstract

Chronic pancreatitis (CP) is a chronic, progressive, inflammatory disease of the pancreas. Pancreatolithiasis is a complication of CP. In this case report, we present a patient with a giant solitary pancreatic stone that necessitated surgery. A 34-year-old patient with CP presented to our outpatient clinic with abdominal pain. Computed tomography revealed near-total atrophy of the pancreatic parenchyma and an 85-mm-long stone within the main pancreatic duct. Due to abdominal pain refractory to medical treatment and the long-term malignancy risk in the near-totally atrophic pancreas, the decision was made to perform surgery based on a multidisciplinary team meeting. Total pancreatectomy was carried out and a 30 × 85 mm pancreatic stone filling the main pancreatic duct was found in the specimen. Intractable pain, local complications of adjacent organs, and suspicion of a malignant lesion are indications for surgery in patients with CP. A case-based clinical approach is necessary for the management of pancreatic stones.

Keywords

• cholangiopancreatography
• endoscopic retrograde; extracorporeal shockwave lithotripsy; general surgery; lithiasis; pancreatitis
• chronic