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A case of acute pancreatitis caused by obstruction of the pancreatic duct with a plant-based broom bristle

Year: 2025

Type: article

Abstract: Acute pancreatitis is an inflammatory disease causing acute abdominal pain. Most cases are mild, but 15%–20% may develop complications leading to organ failure and mortality [1]. Causes include metabolic issues, injury, drugs, ischemia, infection, and genetic damage [1]. Biliary and pancreatic duct obstruction is a common factor. Biliopancreatic duct obstruction can result from stones, inflammation, tumors, congenital abnormalities, and other diseases [1]. Foreign body-induced obstruction is rare. Here, we report a case where a foreign body in the pancreatic duct caused acute pancreatitis. A 57-year-old woman was referred to our hospital for evaluation and management of acute pancreatitis of unknown etiology. After the patient was admitted to the hospital, laboratory tests, upper abdominal ultrasound, and enhanced computed tomography (CT) scans of the patient all indicated acute pancreatitis. After five days of routine treatment, the patient showed no significant improvement. The patient was recommended to undergo gastroscopy and endoscopic ultrasound to identify the cause of the pancreatitis. Gastroscopy revealed purulent secretions and a foreign body in the duodenal papilla ([ Fig. 1 ]). Endoscopic ultrasound (EUS) detected high echogenicity in the main pancreatic duct, suggesting a foreign body ([ Fig. 2 ]). The foreign body was successfully grasped and extracted using biopsy forceps ([ Video 1 ]). Fig. 1 Endoscopic images depicted a foreign body entrapped in Vater's papilla, with protrusion into the lumen of the duodenum. Fig. 2 Ultrasound endoscopic image. Before foreign body removal (the green arrow points to the foreign body). Download Video of endoscopic removal of gallbladder and pancreatic duct foreign bodies.Video 1 After the foreign body was removed, a repeat EUS showed the disappearance of the hyperechoic shadow in the main pancreatic duct, with mild wall roughness and no significant dilation ([ Fig. 3 ]). The extracted foreign body was identified as a 5.5-cm plant-based broom bristle ([ Fig. 4 ]). Fig. 3 Ultrasound endoscopic image. After foreign body removal (the red arrow points to the main pancreatic duct). Fig. 4 Photo of the foreign body. The patient improved after surgery, denied any history of foreign body ingestion when questioned, and continued with anti-inflammatory therapy. She was discharged three days later after clinical improvement and remained relapse-free during follow-up. The occurrence of pancreatitis due to pancreatic duct obstruction is rare. CT scans usually detect foreign bodies accurately, but missed diagnoses can happen in specific cases [ 4 ]. In this case, neither CT nor ultrasound revealed foreign bodies, and the patient did not report ingestion history. Further EUS examination identified a foreign body as the cause of pancreatitis. Physicians should remain vigilant and use appropriate diagnostic methods for complex cases. Endoscopy_UCTN_Code_CCL_1AB_2AF Endoscopy E-Videos https://eref.thieme.de/e-videos E-Videos is an open access online section of the journal Endoscopy , reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/ ). This section has its own submission website at https://mc.manuscriptcentral.com/e-videos . Publication History Article published online: 04 September 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/). Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Source: Endoscopy

DOI: 10.1055/a-2689-3319

Authors: Tan Chen, Shuhui Zhang, Mingwei Fan, Aili Wang, Yan Chen, Xianyong Cheng

Institution: Binzhou Medical University

Language: English

Topic: Pancreatitis Pathology and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funder: Natural Science Foundation of Shandong Province