Hypertensive pancreatic duct sphincter as a cause of pancreatitis. Successful treatment with hydrostatic balloon dilatation.

Four patients with recurrent episodes of acute pancreatitis, despite surgical sphincteroplasty in three and duodenoscopic sphincterotomy in one, are described. All patients were diagnosed by endoscopic pancreatic sphincter manometry confirming the diagnosis of a hypertensive pancreatic sphincter. Hydrostatic balloon dilation of the pancreatic sphincter was successfully employed as a single therapeutic modality. It is likely that more widespread use of these techniques will lead to an increase in the reported incidence and to a nonsurgical treatment in a condition previously thought to be rare.