ESWL as an alternative management of pancreatic lithiasis – case report

Pancreatic lithiasis is a condition rarely seen in the paediatric population. Small pancreatic deposits are treated with endoscopy. For patients with anatomical anomalies, surgery must be performed. Patients already operated on or with no coexisting anomalies may benefit from less invasive treatment. Extracorporeal shock wave lithotripsy (ESWL) is a method dedicated to the treatment of urolithiasis, but since 1989 it has been used for the management of pancreatic stones in the adult population. The aim of this paper is to present the case of a 13-year-old patient with pancreatic lithiasis treated with a combination of endoscopic procedures followed by ESWL of the pancreas. Endoscopic retrograde cholangiopancreatography followed by ESWL were performed. Using the frequency of 1 Hz, and 1,500 pulses, very good disintegration of the deposits was obtained. No complications were observed. ESWL with a combination of endoscopic procedures is an effective and low-invasive method of treating pancreatic stones, and may be used in children.