Management of Chronic Pancreatitis with Pancreatic Duct Calculi

Chronic pancreatitis (CP) is a progressive inflammatory disorder of the pancreas characterized by irreversible fibrosis and intraductal calculi, leading to recurrent abdominal pain and functional impairment. Here, we present the case of a 37-year-old female, 2 months postpartum with a history of gestational diabetes, who presented with 1 month of worsening epigastric pain radiating to the back, aggravated after meals, and associated with nausea and nonbilious vomiting. Laboratory investigations were unremarkable except for mildly elevated HbA1c, while imaging revealed multiple large calculi within the main pancreatic duct, confirming chronic calcific pancreatitis. Conservative management failed to relieve symptoms, necessitating surgical intervention. She underwent lateral pancreaticojejunostomy (Partington-Rochelle procedure) with intraoperative extraction of ductal calculi. Postoperative recovery was uneventful, and at 6-week follow-up, she reported complete resolution of symptoms with improved quality of life. This case emphasizes the importance of timely diagnosis and surgical management in CP with ductal obstruction.