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April 2, 2008, ST. LOUIS - Nineteen-year-old Daniel Ederer has been to hell and back.

It began with minor stomach pains in August, but by the end of September the pain had rendered him incapacitated. He could not stop vomiting nor could he eat.

“It felt like someone was taking a cheese grater to my stomach,” he said. “The pain became so severe that I finally had to go to the emergency room.”

A doctor in Poplar Bluff, Mo., about 30 miles northeast of Ederer''s hometown of Doniphan, Mo., diagnosed him with pancreatitis, a painful and potentially serious condition that occurs when the pancreas is inflamed.

Ederer''s attack of pancreatitis was caused by a gallstone that passed through his bile duct, irritating the pancreas and triggering severe inflammation. The pancreas produces vital hormones like insulin and secretes the enzymes that help in digesting food. When the pancreas is irritated, the enzymes are released within the pancreas, which then digests itself.

Due to the severe inflammation, a large fluid collection called a pancreatic pseudocyst developed around Ederer''s pancreas. The pseudocyst was nine inches in diameter and was compressing his stomach and stretching his abdomen. He could not eat or drink and was experiencing excruciating pain.

Ederer was rushed to Barnes-Jewish Hospital, where an interventional endoscopy team led by Riad Azar, MD, a Washington University gastroenterologist at Barnes-Jewish, performed an endoscopic ultrasound - in which a long, thin tube called an endoscope is inserted through the mouth - to find the pseudocyst. Then they created a small hole through the wall of the stomach, drained two liters of fluid from the cyst, and placed stents to prevent further accumulation of fluid.

This technique of using endoscopic ultrasound to drain pancreatic pseudocysts was developed by Dr. Azar and his colleagues at Barnes-Jewish Hospital.

“This is a minimally invasive procedure that allows us to safely treat complications of pancreatitis,” said Dr. Azar. “The alternative for Daniel would have been to undergo an open surgical procedure with a longer recovery time.”

A few days following the procedure, the pain had subsided. Ederer could eat and drink again on his own, prior to which he was being fed through a catheter. He was discharged from Barnes-Jewish Hospital on Christmas Day, nearly four months after his ordeal started.

Today, Ederer is pain-free with the pseudocyst completely resolved. He will return to Barnes-Jewish Hospital on April 9-10 to have the stents in his pancreas and gallbladder removed.

“Dr. Azar says there is still a chance that I may have problems in the future but I think I''ll be fine,” he said.

Ederer, who had just graduated from high school a few months prior to his illness, hopes to enroll in college in the fall to study music.