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Why is my friend having severe abdominal pain?

Q: My 22 years old friend suffered from chronic pancreatitis and underwent Frey's procedure 5 years ago. Now he has fever and severe abdominal pain again, which lasts only for 2 days but he could feel the similarity between this pain and the last pain before surgery. He has done an ultrasonography of the pancreas, which stated - post operative follow-up case showing slightly heterogeneous pancreatic, parenchyma with multiple foci of calcification within the parenchyma. Main pancreatic duct is mildly dilated (about 3.9 mm) along with few tiny ductal calculi. Is there anything serious? Is any further surgery needed or any restriction of food? Please advise.

A:Five years back your friend underwent Frey’s procedure for chronic pancreatitis with fairly good result. Frey’s procedure is done for multiple pancreatic stones in the main pancreatic duct and it branches in the head of the pancreas. The Ultra-sonography now shows multiple foci of parenchymal calcification while the pancreatic duct is only mildly dilated. The pain according to you is not similar to the previous pain 5 years ago and therefore may not be significant. Repeat operation will be a major undertaking for which the patient needs to be fully evaluated. Operation for chronic pancreatitis is performed as a last resort when all other avenues of treatment have failed and the pain makes life unbearable.

You should get your friend examined by a gastro-intestinal surgeon who after examining and further investigating him will be able to advise him appropriately. It may be a good idea to visit the surgeon who first operated on him 5 years ago with good result.

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