CONGENITAL DUODENAL WEB EXCISED ENDOSCOPICALLY IN AN ADULT PATIENT WITH RELAPSING ACUTE PANCREATITIS

A 26-year-old man came to our hospital with the chief complaint of abdominal pain. Based on the results of endoscopy and duodenography, the patient was diagnosed as having pancreatitis caused by a duodenal web. From childhood, the patient had frequently experienced postprandial abdominal distension and vomiting. After the age of 20 years, he had relapsing pancreatitis. When a part of the web was endoscopically excised, the symptoms disappeared. The preoperative relationship between the location of the duodenal papilla and the web is unclear in most cases of duodenal web. Therefore, in order to safely perform endoscopic treatment of duodenal webs, a small incision of the web should be initially made with duodenographic guidance. Subsequently, the relationship between the duodenal papilla and the web should be confirmed by endoscopic retrograde cholangiopancreatography and the remaining web should be excised.