An anatomical‐radiological study on the pancreatic duct pattern in man

Dawson, William F.; Langman, Jan

doi:10.1002/ar.1091390109

Cited by 148 publications

(66 citation statements)

References 13 publications

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“…This coincides with studies done by Toda et al [18]and Dawson and Langman [19]. Mc carthy et al [20] has reported only 21 % accessory ducts in his study population. Karak et al [15], studied normal endoscopic pancreatograms and the duct of Santorini was visualised in 6.6 per cent subjects.…”

Section: Discussionsupporting

confidence: 91%

Variations in the Duct System of Pancreas: A Cadaveric Study

Govindraj¹,

Shabna²

2017

IJAR

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Background: Recently there has been growing interest in the duct system of pancreas as concerns its relationship with various disease processes as well as newer investigatory and treatment modalities related to them.This study has been aimed at evaluating the anatomy of the pancreatic duct system, thus identifying the variants to improve our knowledge of it and make things easier. The pancreas is formed by the fusion of the ventral and dorsal anlage, and a wide spectrum of anomalies or anatomical variations may appear related to this complicated process of fusion: e.g., agenesis, aplasia of a pancreatic anlage, hypoplasia, annular pancreas, pancreas divisum or nonfusion of the ventral and dorsal duct system, pancreaticobiliary maljunction, etc. Every endoscopist who engages in pancreatography or related diagnostic and therapeutic procedures should always be aware of all sorts of anatomical variations he or she might encounter.

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Section: Discussionsupporting

confidence: 91%

Variations in the Duct System of Pancreas: A Cadaveric Study

Govindraj¹,

Shabna²

2017

IJAR

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“…During development, as the duodenum rotates to the right and becomes C-shaped, the ventral pancreatic bud is carried dorsally with the bile duct. The ventral pancreatic duct joins the distal portion of the dorsal pancreatic duct to form the main pancreatic duct, which merges with the common bile duct, inserting into the duodenum via the papilla of Vater [10] . Then, the proximal portion of the dorsal pancreatic duct gradually regresses and becomes obliterated at the junction with the ventral pancreatic duct.…”

Section: Discussionmentioning

confidence: 99%

A rare case of periampullary carcinoma with ectopic ending of Vater’s ampulla

Jin¹,

Chen²,

Yan³

et al. 2009

WJG

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A 71-year-old woman was referred to our department complaining of painless progressive jaundice for the last 3 mo. Magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRCP) showed the ectopic hepatopancreatic ampulla draining into the fourth part of the duodenum adjacent to the duodenojejunal flexure; the irregular morphology of the duodenojejunal flexure likely due to a soft tissue mass. Laparotomy confirmed the presence of the abnormal ampulla of Vater located at the fourth part of the duodenum and a soft tissue tumor about 6 cm × 5 cm × 5 cm with a peduncle adjoining the ampulla. Resection of the tumor, including some peripheral tissue, and a Roux-Y loop anastomosis choledochojejunostomy were performed. Pathological examination indicated an intestinal villous adenoma accompanied by severe dysplasia and focal canceration. Periampullary carcinoma with ectopic ending of the Vater's ampulla into the fourth part of the duodenum is rather rare. The embryonic genetic background of this anomaly has not yet been fully explained. It is worth mentioning that MRCP is useful for demonstrating anomalies and anatomic variants of the biliary tract system and pancreatic duct.

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“…The frequency of pancreas divisum in Western countries ranges from 4% to 14% in autopsy series and from 2% to 8% in ERCP series (43)(44)(45)(46). Because the major part of the pancreatic secretion must flow through the minor papilla, patients with pancreas divisum are at a higher risk for obstructive pancreatopathy, caus ing both pancreatitis and pancreatic type pain, up to the development of severe chronic pancreatitis.…”

Section: Recurrent Episodes Of Acute Pancreatitismentioning

confidence: 99%

Secretin-enhanced MR Imaging of the Pancreas

Manfredi¹,

Mucelli²

2016

Radiology

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1Secretin is a hormone that stimulates the exocrine pancreatic secretion of bicarbonate-rich fluid from the acinar cells of the pancreas that accumulates within the pancreatic ductal lumen. The exogenous administration of secretin improves the visualization of pancreatic ducts at magnetic resonance (MR) cholangiopancreatography (MRCP), because of an enlargement of the pancreatic duct system and an increase of the fluid content within the lumen of the pancreatic ducts, responsible of an increase of MR signal. In this review, the technique of secretin-enhanced MRCP, which has the aim to depict the whole pancreatic duct system, the biliary tree, the major and minor papillae, and the duodenum, will be described. Because of the anatomic contiguity between the pancreas and the gastrointestinal tract, the presence of fluid within the stomach may overlap with the pancreatic duct system and therefore the pancreatic duct may be difficult to visualize, representing a potential source of diagnostic pitfalls. The technique to reduce the signal intensity of the static fluid present within the stomach and in the duodenal lumen is also described. The technique of secretin administration will be illustrated, with emphasis on the synchronization of secretin administration and MR image acquisition. Furthermore, the frequency and number of MRCP images necessary to achieve a temporal resolution adequate to visualize the physiologic changes in the pancreatic gland, induced by the administration of secretin, is described. The assessment of pancreatic, morphologic, and functional response to the administration of secretin, as depicted on MRCP images, will be illustrated. Finally, the indications for secretin-enhanced MRCP will be discussed to define which patients will benefit from secretin-enhanced MR imaging for their treatment planning. © RSNA, 2016 This copy is for personal use only. To order printed copies, contact reprints@rsna.org I n recent years, magnetic resonance (MR) imaging has increased its role in the detection and characterization of pancreatic diseases. This is most likely due to the capability of MR imaging to simultaneously assess the pancreatic parenchyma and the pancreatic and bile duct systems. This can be achieved by obtaining cross-sectional MR images by using breath-hold T1-weighted gradient-echo sequences performed as two-or three-dimensional gradient-echo, fat-suppression techniques; T2-weighted half-Fourier pulse sequences; diffusion-weighted imaging; and dynamic contrast material-enhanced imaging following the administration of gadolinium chelates that are able to depict and characterize focal pancreatic masses and evaluate diffuse pancreatic diseases. Furthermore, MR cholangiopancreatography (MRCP) is STATE OF THE ART: Essentialsn Secretin-enhanced magnetic resonance cholangiopancreatography (MRCP) is indicated in patients with chronic asymptomatic hyperenzymemia, recurrent acute pancreatitis, sphincter of Oddi dysfunction, anatomic variants, chronic pancreatitis, and main pancreatic duct stenosis.n Se...

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An anatomical‐radiological study on the pancreatic duct pattern in man

Cited by 148 publications

References 13 publications

Variations in the Duct System of Pancreas: A Cadaveric Study

Variations in the Duct System of Pancreas: A Cadaveric Study

A rare case of periampullary carcinoma with ectopic ending of Vater’s ampulla

Secretin-enhanced MR Imaging of the Pancreas

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