Mumbai/Kolkata, Nov 12: Doctors have successfully treated Sonal Chauhan, a 3.5-year-old girl from Hooghly, in a rare and unique case involving the use of an advanced endoscopic technique to treat a post-necrotic collection. The procedure, generally performed on adult patients, was successfully carried out on a child as young as 3.5 years, making it a significant clinical achievement in paediatric care. The condition had resulted in a persistent fluid collection in the pancreatic region, which was compressing the stomach and affecting the child's ability to eat and gain weight. The medical team opted for Endoscopic Ultrasound-guided drainage with a Lumen-Apposing Metal Stent to successfully treat the condition.
Baby Chauhan was initially admitted in July this year with severe pancreatitis, which led to a disruption in the pancreatic duct and leakage of pancreatic fluid into the surrounding area, resulting in a fluid collection. Although the pancreatic duct leak subsequently healed, the collection persisted and developed into a pancreatic pseudocyst. The condition began compressing the stomach, causing recurrent abdominal pain, difficulty in eating and below optimal body weight. As the condition did not resolve on its own, the team of doctors under the stewardship of Dr Bhaswati Chakrabarti Acharyya decided that further intervention was necessary.
A post necrotic collection is a fluid-filled collection that develops around the pancreas, usually following inflammation of the organ. Depending on its size and location, it can cause abdominal pain, compress the stomach or intestines, and interfere with normal food intake. In some cases, it may also lead to complications such as bleeding or rupture. Treatment options include endoscopic drainage, radiological drainage and conventional surgery. Considering the patient’s young age, the doctors opted for an endoscopic approach, as it avoids a major surgical procedure and the potential risk of a persistent fistula associated with external drainage. However, performing this procedure on a child as young as 3.5 years was particularly challenging, as the specialised equipment is generally used for adults. The child is now recovering well, and one of the stents is scheduled to be removed within the next one to two weeks.
While speaking about the case, Dr. Pradeepta Kumar Sethy, Director & Senior Consultant-Medical Gastroenterology, Manipal Hospital, EM Bypass said,
“Treating a pancreatic pseudocyst in a child as young as three-and-a-half years requires careful clinical assessment and specialised expertise. While endoscopic drainage is an established approach in adults, performing it in such a young child presents additional technical challenges. In this case, we carefully evaluated the available treatment options and opted for an Endoscopic Ultrasound-guided procedure using a Lumen-Apposing Metal Stent to drain the fluid collection. The procedure was successful, and the child has responded well to the treatment. This case demonstrates how advanced endoscopic techniques can help manage complex conditions through minimally invasive approaches, even in younger patients."
Commenting on the child's recovery and the importance of timely intervention in paediatric pancreatic conditions, Dr. Bhaswati Chakrabarti Acharyya, Senior Consultant - Paediatric Gastroenterology, Manipal Hospital, Mukundapur, shared,
“Pancreatitis in children can have several underlying causes, including genetic factors and, in some cases, gallstones. However, in many children, the exact cause may remain unidentified. In Sonal’s case, the persistent pancreatic pseudocyst was affecting her ability to eat and gain weight, making timely intervention important. We are pleased to see that she is now recovering well, with no recurrence of abdominal pain and normal food intake. She will continue to remain under medical follow-up, with prescribed medication and ultrasound examinations to monitor her recovery. The stent is scheduled to be removed in the coming days.”
Highlighting the importance of specialised endoscopic care in managing complex paediatric cases, Dr. Prasanta Debnath, Consultant – Medical Gastroenterology, Manipal Hospital, EM Bypass said,
“Pancreatic pseudocysts in children require careful evaluation, as persistent fluid collections can lead to complications and significantly affect a child's nutrition and overall growth. In this case, the challenge was to address the collection effectively while minimising the risks associated with more invasive procedures, particularly given the child's young age. Endoscopic Ultrasound-guided drainage using a Lumen-Apposing Metal Stent provided an effective approach to managing the condition. Such interventions require precise assessment, specialised expertise and close monitoring to ensure favourable outcomes. The successful treatment in this case reflects the growing potential of advanced endoscopic procedures in addressing complex gastrointestinal conditions in paediatric patients.”
The case highlights the growing role of advanced endoscopic techniques in managing complex pancreatic conditions, including in younger patients. It also reflects the importance of individualised treatment planning, specialized clinical expertise and minimally invasive approaches in delivering effective care for paediatric patients.
