Treatment of Wirsungocele Induced Chronic Pancreatitis by Endoscopic Retrograde Cholangiopancreatography and Stent Placement: A Case Report

Background

Wirsungocele is a rare cystic dilatation of the terminal main pancreatic duct, analogous to choledochocele and santorinicele. It has been associated with recurrent acute or chronic pancreatitis, though its pathogenesis remains unclear. Diagnostic imaging such as MRCP and ERCP plays a pivotal role, and endoscopic intervention is considered the gold standard treatment.

Case Report

A 10-year-old boy presented with recurrent abdominal pain and fever since age four, diagnosed repeatedly with acute pancreatitis. Imaging via CT, MRCP, and ERCP revealed focal saccular dilation of the distal pancreatic duct consistent with Wirsungocele, along with pancreatic duct stricture and stones. The patient underwent ERCP with pancreatic sphincterotomy, extraction of cheesy material, and placement of a 5 Fr × 5 cm pancreatic duct stent. Post-procedure, the patient showed marked clinical and radiological improvement with no recurrence of symptoms at one-month follow-up.

Conclusion

This case highlights a rare pediatric presentation of Wirsungocele-induced chronic pancreatitis successfully managed with ERCP and stent placement. Early recognition and intervention can lead to significant symptomatic relief and ductal improvement. Further long-term follow-up is necessary to evaluate recurrence and guide future management.