The patient was a 22 year-old male. Hereditary chronic pancreatitis was sus
pected as a diagnosis since his mother's uncle had been operated on for chr
onic pancreatitis 14 years previously at the age of 64 years and his mother
had been operated on for chronic pancreatitis with calculi 5 years previou
sly at the age of 40 years. Surgery was needed, since: 1) he had experience
d abdominal pain for 8 years; 2) endoscopic retrograde cholangiopancreatogr
aphy(ERCP) revealed a marked irregular dilatation in the main pancreatic du
ct and a marked irregular dilatation and protein plugs in the ductule of th
e tail of the pancreas; and, 3) pancreatic functional diagnostic (PFD) test
examination showed a 75% decrease in exocrine function. If a surgical proc
edure had not been performed, the patient would likely have experienced cal
culi formation in the pancreas and a further decrease in exocrine function.
Since the patient was very young and had many protein plugs in the dilated
ductule of the tail of the pancreas, we decided to perform a spleen-preser
ving Puestow's procedure with removal of the tail of the pancreas. Clinical
and pathological findings of hereditary pancreatitis are reviewed.