Idiopathic fibrosing pancreatitis in a 3-year-old girl: a case report and review of the literature

Successful conservative management of idiopathic fibrosing pancreatitis in children

“…It is often associated with obstructive jaundice due to compression of the common bile duct (CBD) as it passes through the swollen head of the pancreas [1]. This association of the common bile duct obstruction and fibrosing pancreatitis has been reported in fewer than 40 patients; a surgical approach to diagnosis and treatment has been advocated in most cases [4,5]. We present three cases of chronic fibrosing pancreatitis; two of them were successfully managed without surgical intervention, whilst the third was treated by endoscopic therapy alone.…”

Idiopathic fibrosing pancreatitis and spontaneous resolution of pancreatic masses in children

“…No precipitating factor can be identified and the serum amylase is normal or mildly elevated. Fifty-seven cases have previously been described with a slight male preponderance (age range 4 months-20 years, mean 10 years) [6][7][8]. Radiological imaging typically demonstrates a pancreatic mass or enlargement with dilatation of the intra and extra hepatic biliary tree where jaundice is present (72% of previously reported cases [6][7][8]).…”

“…Fifty-seven cases have previously been described with a slight male preponderance (age range 4 months-20 years, mean 10 years) [6][7][8]. Radiological imaging typically demonstrates a pancreatic mass or enlargement with dilatation of the intra and extra hepatic biliary tree where jaundice is present (72% of previously reported cases [6][7][8]). Histology shows fibrosis of the pancreas with relative preservation of acinar structure and no evidence of auto digestion [8][9][10].…”

“…In many patients this has been accompanied by a definitive drainage procedure. The latter includes: cholecystduodenostomy [8][9][10], choledochoduodenostomy [6,[8][9][10][11], choledochojejunostomy [8,9,12] and cholecystjejunostomy [8,13]. More minor procedures undertaken at the time of exploratory surgery include sphinterotomy [14,15] and transduodenal sphincteroplasty [14,16].…”

“…Tropical pancreatitis, common in certain regions of the tropics, also presents in childhood and adolescence with pain and diabetes [5]. Idiopathic fibrosing pancreatitis is a rare cause of obstructive jaundice and abdominal pain in childhood and adolescence with some 57 cases previously reported in the literature [6][7][8], over half of whom had obstructive jaundice. Little data is available on its natural history.…”