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Chronic pancreatitis at early age of onset presenting interesting findings through endoscopic retrograde pancreatography and chemical analysis of nonopaque pancreatic concretion

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Summary

This case concerns a 20-year-old male patient with an approximate 10-year history of recurrent and severe abdominal pain radiating to the back. Endoscopic retrograde cholangiopancreatography revealed a short obstructing stenosis of the main pancreatic duct in the head of the pancreas, marked and tortuous dilatation of the prestenotic portion of the main pancreatic duct and its side branches, and a filling defect in the side branch in the body of the gland. Pancreaticojejunostomy was performed to induce decompression of the pancreatic duct. Histology of the pancreas showed advanced chronic pancreatitis. Three nonopaque concretions were obtained at operation. The largest one, which was milky white in appearance and elastic and soft in consistency, proved to be made up of protein. The concretion was rich in acidic amino acids, but poor in basic or aromatic residues. The molar composition of amino acids in the concretion was, in decreasing order, aspartic acid, serine, valine, glycine, and glutamic acid. Powder x-ray diffractometry revealed no crystalline structures.

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Authors and Affiliations

  1. Second Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan

    Aiji Noda MD, Hirotsugu Hamano MD, Tokimune Shibata MD, Tetsuo Hayakawa MD, Kenji Tsuchie MD, Yuji Nimura MD & Yutaka Nakanishi PhD

  2. First Department of Surgery, Nagoya University School of Medicine, Nagoya, Japan

    Aiji Noda MD, Hirotsugu Hamano MD, Tokimune Shibata MD, Tetsuo Hayakawa MD, Kenji Tsuchie MD, Yuji Nimura MD & Yutaka Nakanishi PhD

  3. Department of Analytical Chemistry, Research Laboratories, Dainippon Pharmaceutical Co. Ltd., Osaka, Japan

    Aiji Noda MD, Hirotsugu Hamano MD, Tokimune Shibata MD, Tetsuo Hayakawa MD, Kenji Tsuchie MD, Yuji Nimura MD & Yutaka Nakanishi PhD

Authors
  1. Aiji Noda MD
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  2. Hirotsugu Hamano MD
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  3. Tokimune Shibata MD
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  4. Tetsuo Hayakawa MD
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  5. Kenji Tsuchie MD
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  6. Yuji Nimura MD
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  7. Yutaka Nakanishi PhD
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Noda, A., Hamano, H., Shibata, T. et al. Chronic pancreatitis at early age of onset presenting interesting findings through endoscopic retrograde pancreatography and chemical analysis of nonopaque pancreatic concretion. Digest Dis Sci 32, 433–440 (1987). https://doi.org/10.1007/BF01296299

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  • DOI: https://doi.org/10.1007/BF01296299

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