A pediatric case of recurrent pancreatitis that was resolved by the frey procedure after endoscopic therapies

A 10-year-old boy who had sudden onset of abdominal pain and vomiting, was diagnosed with severe acute pancreatitis and referred to our hospital. Intensive care successfully suppressed inflammation in the acute phase, and infection of walled-off necrosis that arose two months after onset was cured by cystojejunostomy. However, the patient had a relapse of acute pancreatitis which might have been caused by stricture of the main pancreatic duct and developed chronic pancreatitis (CP). Although inserting stents through the main pancreatic duct and performing minor papilla sphincterotomy as pancreatic duct drainage were temporarily effective, pancreatitis relapsed. Eventually, he underwent the Frey procedure nine months after the first onset. Five years after the surgery, relapse of pancreatitis and pancreatic functional impairment have not been seen. It is important to determine the appropriate timing of surgical intervention considering the limits of endoscopic procedures for pediatric CP cases, in which the long-term prognosis including pancreatic function should be focused on.