Relapsing pancreatitis due to juxta-pancreatic duodenal duplication cyst with pancreatic ductal communication.

A 21 year old patient first presented with acute pancreatitis in infancy, followed by subsequent episodes of relapsing pancreatitis in childhood. The cause of the pancreatitis defied diagnosis, despite two laparotomies in infancy and childhood, until twenty years later when a juxta-pancreatic duodenal duplication--a rare congenital lesion--was finally discovered. The duplication communicated with the main pancreatic duct via a long, aberrant duct, resulting in the relapsing pancreatitis. Abdominal ultrasonography and computerized tomography scan, and endoscopic retrograde cholangiopancreaticogram were useful in demonstrating the lesion. Surgical excision of part of the cyst, with marsupialization of the remaining structure to the stomach, abolished further symptoms and recurrence of pancreatitis.