Incision and plasty of the descending duodenal diverticulum using an ESD technique in a child with acute pancreatitis: a case report.

A 10-year-old boy presented with recurrent abdominal pain and vomiting for over a 20-month period. He had previously been diagnosed with recurrent acute pancreatitis at local hospitals and treated conservatively, but the symptoms continued to recur. Upon admission, a comprehensive diagnostic evaluation was undertaken, which ruled out the majority of established causes of pediatric pancreatitis. It was postulated that the diverticulum itself may have led to intermittent duodenal obstruction and contributed to the recurrent episodes of pancreatitis. The patient subsequently underwent incision and plasty of the descending duodenal diverticulum using an endoscopic submucosal dissection (ESD) technique. At one-year follow-up, the patient's serum amylase and lipase levels remained within normal ranges. Although the absence of recurrent pancreatitis postoperatively strongly suggests that the intraluminal duodenal diverticulum (IDD) was the underlying etiology, definitive causation cannot be established based on a single case report with a follow-up period of only one year.