The Telegraph
Since 1st March, 1999
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Cure for ‘hidden’ pancreas problem

A rare condition, missed by doctors in Dhaka for years, was corrected through a minimally invasive surgery at a city medical centre recently, holding out fresh hope for a beleaguered Bangladeshi family and others with a similar ailment this side of the border.

Siddiqure Rahman Rana had been going round in circles since 1995, trying to find a permanent cure for the chronic pain in his upper abdomen, perennially poor appetite and a steady loss of weight. Doctors in Dhaka blamed it on pancreatitis, or inflammation of the pancreas. “But they were unable to put their finger on the cause and wanted to remove the pancreas entirely,” recalls the 26-year-old.

Siddiqure eventually landed up in Calcutta with his cousin brother, after having watched a programme on a Bengali satellite channel on pancreatitis conducted by Mahesh K. Goenka, chief gastroenterologist, Apollo Gleneagles Hospitals.

The CT scans done in Dhaka had revealed a pancreatic mass, on which a biopsy was done. Since the doctors couldn’t find any malignancy, an ERCP (endoscopic retrograde colangio pancreatography) was attempted. But the procedure was not completed, as the patient’s pancreatic duct couldn’t be located.

So doctors there suggested removal of the entire diseased organ — a surgery that would have cost Siddiqure Rs 3 lakh, something he could not afford.

“The reason doctors in Dhaka couldn’t locate the pancreatic duct was that it didn’t arise from the normal position,” explains Goenka, under whom the youngster was admitted at Apollo Gleneagles.

Goenka did another ERCP, which revealed ‘pancreas divisum’ — the duct arising from an abnormal site. The opening was unusually small and couldn’t take the load of the pancreatic juice, causing pancreatitis.

“It is an extremely rare condition, and among the 7,000 ERCPs we have done, there have been hardly eight to 10 cases of pancreas divisum,” says Goenka, who treated Siddiqure by papillotomy, an endoscopic procedure, at his Eko Endoscopy Centre on JL Nehru Road.

The drainage point of the pancreas was cut open into the intestine and a stent inserted temporarily to hold the channel together.

“I am feeling fine and there is no pain now,” said Siddiqure on his way back to Dhaka. “There is an 80 per cent chance that he will be fine and the problem won’t recur for the rest of his life, and just a small probability of the procedure having to be repeated,” observes Goenka.

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