A 50-year-old lady, a known case of chronic pancreatitis due to SPINK-1 mutation, presented with recurrent pain abdomen and vomiting suggestive of acute exacerbation. Endoscopic ultrasound (EUS) showed dilated pancreatic duct in the distal body and tail regions with calculi. Under EUS guidance, pancreatic duct cannulation was done from the stomach, confirmed under fluoroscopy. Stricture noted in the pancreatic duct at the head region with three stones proximal to it. Pancreatic duct cannulation was done using the rail road technique. Pancreatic sphincterotomy done and 7F PD stent was placed. No immediate complications noted and the patient is asymptomatic after the procedure. Patient improved symptomatically and now on routine follow-up.
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Prabhakar et al. (2024) studied this question.
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