Pancreatic ERCP With A Frontal View Endoscope In A Patient With Preserved Duodenal Anatomy Without Previous Surgery

Patient with alcoholic chronic pancreatitis under endoscopic therapy with stents for pancreatic stenosis (PS). After one year treatment is admitted for definitive removal of the stent. An inflammatory stenosis is found in the upper duodenal flexure preventing duodenoscope progression. Access to the papillary area is achieved with a gastroscope and the stent is removed. Worsening of the duodenal inflammatory proccess raised the suspicion of concurrent worsening of the PS so the papilla is laterally and proximmally approached with the gastroscope and cannulation is achieved using a rotatory sphincterotome. Pancreatography confirmed worsening of the PS so another stent was inserted laboriously.