Normal and anomalous pancreaticobiliary union in children and adolescents

Recurrent Acute Pancreatitis: Clinical Profile and an Approach to Diagnosis

“…A reason for the reduced frequency of biliary pancreatitis in recent Western studies may be the tendency to perform early cholecystectomy or biliary sphincterotomy after an episode of acute pancreatitis. Other structural causes like anomalous pancreato-biliary union, choledochal cyst, duodenal diverticulum, and metabolic causes like hypertriglyceridemia and hypercalcemia were seen in a small number of patients [4,8,19,20]. Multiple etiologies were detected in 13 (7%) patients.…”

“…Anomalous union of pancreaticobiliary duct was diagnosed when the junction of the bile duct and the pancreatic duct was at a proximal site with a long ([15 mm) common pancreaticobiliary channel [19].…”

Potential diagnostic value of pancreatic isoamylases for pancreaticobiliary maljunction with mild biliary dilatation in patients and a porcine model

“…It is proposed that the diagnosis of PBM can be made when the common channel is longer than 5 mm in children and adolescents up to 15 years of age. 4 The diagnosis is also strongly suspected on the basis of a high level of total amylase activity in bile. 2 With increasing accumulation of the literature on the relationship between CC and PBM, it has been suggested that PBM be integrated into the classification system.…”

“…This PBM configuration permits free reflux of pancreatic juice into the biliary tract, leading to recurrent bouts of cholangitis, cyst formation, pancreatitis, or even malignancy of the biliary system. [1][2][3][4] PBM can be diagnosed easily after the detection of typical cystic dilatation. Unfortunately, not all patients with PBM have obvious biliary dilatation.…”

ERCP in children

“…The maximum normal length of the common channel in neonates and infants younger than 1 year is 3 mm. It increases with age to a maximum of 5 mm in children and adolescents between 13 and 15 years of age [29].…”