Pancreatic Adenocarcinoma on the Dorsal Part of the Pancreas Divisum Presenting as Acute Recurrent Pancreatitis

Katsinelos, P; Xiarchos, Panagiotis; Koutras, Christos; Tsoykalas, I; Augerinos, A.; Katsos, Ioannis

doi:10.1097/00004836-199707000-00029

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…In many cases, a zone of inflammation surrounds a small pancreatic cancer [9]. Pancreatitis in only the dorsal component of a pancreas divisum may present as focal relapsing inflammation [15]. Another unfortunate association between cancer and inflammation exists, as many patients with a suspicion of pancreatic carcinoma automatically undergo endoscopic retrograde cholangiopancreatography (ERCP); this places them at risk of developing post-ERCP pancreatitis, further clouding the clinical and radiologic picture, and undoubtedly delaying possible curative surgery if a cancer is present.…”

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confidence: 99%

Carcinoma of the Head of the Pancreas versus Chronic Pancreatitis: Diagnostic Dilemma with Significant Consequences

Taylor

2003

World j. surg.

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Although carcinoma of the head of the pancreas and chronic pancreatitis are usually easy to distinguish on clinical presentation and subsequent investigation, there can be enough overlap in the presenting features and on imaging studies that differentiation is sometimes extremely difficult. As this confusion may lead to either major pancreatic resection for benign disease, or rejection of surgery for a potentially curable lesion, all attempts to arrive at a correct diagnosis should be pursued. This article provides an update of investigative techniques in pancreatic disease, and offers an algorithm for the clinical approach to the patient who appears to present with this diagnostic and therapeutic dilemma.

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Carcinoma of the Head of the Pancreas versus Chronic Pancreatitis: Diagnostic Dilemma with Significant Consequences

Taylor

2003

World j. surg.

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“…Kasos galvos vëþys gali sukelti ûminá pankreatità, kuriam bûdinga kasos latako obstrukcija, distalinës kasos dalies lëtinis uþdegimas ir net pseudocistos. Nedidelá kasos navikà daþniausiai supa uþdegimo zona [14], o pankreatitas tik nugarinëje kasos dalyje gali pasireikðti lokaliu uþ-degimu, primenanèiu auglá [15]. Pankreatitas gali bûti sukeltas ir kitos histologinës struktûros kasos navikø (neuroendokrininiø), kuriø raidos prognozë yra geresnë nei kasos latakø adenokarcinomos [16,17].…”

Section: Klinikaunclassified

Kasos galvos vėžio ir lėtinio pankreatito diagnostikos keblumai

Brimienė¹,

Brimas²,

Strupas³

2006

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A p þ v a l g a Ávadas / tikslasKlinikinëje praktikoje daþnai susiduriama su sudëtinga kasos þidininiø pokyèiø diferencine diagnostika, kai simptomatika ir instrumentiniø tyrimø duomenys neleidþia nedvejojant patvirtinti diagnozës. Ðios literatûros apþvalgos tikslaspateikti medicinos literatûros duomenis apie kasos þidininiø pokyèiø diagnostikos bûdus, jø tikslumà ir efektyviausià kasos vëþio bei lëtinio pankreatito diferencinës diagnostikos algoritmà. RezultataiNorint pasiekti gerà kasos vëþio gydymo rezultatà, bûtina anksti diagnozuoti ligà ir atlikti radikalià chirurginae operacijà. Lëtinio pankreatito gydymas ávairus -nuo simptominio, kuris paprastai atliekamas nechirurginiais metodais, iki operacinio, taikomo gana nedidelei grupei pacientø. Nors pastaruoju metu labai patobulëjo visi radiologiniai kasos þidininiø pokyèiø tyrimo metodai, diferencijuoti lëtiná pankreatità ir kasos vëþá, ypaè ankstyvosiomis jo stadijomis, iðlieka sunku. Ðiuolaikiniai tyrimo bûdai labai sumaþino klaidø skaièiø, taèiau net 5-10% kasos rezekcijø yra nepateisinamos, nes galutinio histologinio tyrimo iðvada yra lëtinis pankreatitas. Daþniausiai rekomenduojamø sonoskopijos, kompiuterinës, magnetinio rezonanso tomografijos, endoskopinës sonoskopijos, serologiniø þymenø tyrimø jautrumas ir specifiðkumas yra riboti, net ir ávairiais metodø deriniais nepasiekiama 100% jautrumo ir specifiðkumo. Absoliutaus tikslumo negarantuoja ir intervenciniai diagnostikos bûdai -kasos biopsija, kontroliuojama sonoskopu, kompiuterine tomografija ar endoskopine sonoskopija. IðvadosRemiantis atlikta literatûros ðaltiniø analize galima teigti, kad moksline patirtimi grásto prieðoperacinio kasos vëþio ir lëtinio pankreatito diferencinës diagnostikos algoritmo nëra. Tolesni tyrimai bûtini siekiant rasti optimalø diagnostikos metodø deriná, todël Vilniaus universiteto ligoninës Santariðkiø klinikø Pilvo chirurgijos centre pradëtas randomizuotas perspektyvusis kontroliuojamas kasos þidininiø pokyèiø diagnostikos metodø tyrimas, kurio tikslas -palyginti dviem ligoniø grupëms taikomus diagnostinius tyrimo metodus pagal kasos þidininiø pokyèiø diferencinës diagnostikos tikslumà, siekiant nustatyti ankstyvos stadijos kasos vëþá ir navikinio proceso iðplitimà.Pagrindiniai þodþiai: lëtinis pankreatitas, kasos vëþys, kasos þidininiai pokyèiai, kasos tyrimas V . B r i m i e n ë , G . B r i m a s , K . S t r u p a s Objective Differential diagnosis of focal pancreatic lesions often remains a dilemma in clinical practice. Our objective was to present the literature data of diagnostic accuracy in focal pancreatic lesions and the most effective algorithm in differential diagnosis of chronic pancreatitis and pancreatic cancer. ResultsThere can be enough overlap in the features and imaging of the carcinoma of the head of the pancreas and chronic pancreatitis, and sometimes the differentiation is extremely difficult. This leads to either a major pancreatic resection for a benign disease in 5-10% of the patients or rejection of surgery for a potentially curable cancer. The dia...

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“…A total of 26 cases of pancreatic cancer associated with pancreas divisum have been reported in Japan. 9 The location in which the tumor developed was the dorsal pancreas in 25 cases and the ventral pancreas in one case; that just the case in the ventral pancreas might be included in the results reported by Nishino et al 8 In an English series, seven cases of pancreatic cancer [10][11][12][13][14][15] and eight cases of IPMN 9,14,16-21 associated with pancreas divisum have been reported, and the tumors developed in the dorsal pancreas except one IPMN in the ventral pancreas. 9 This preponderance in the dorsal pancreas might not be fully accounted for by the larger volume of the dorsal pancreas.…”

mentioning

confidence: 99%

Is there a causal relation between pancreas divisum and pancreatic cancer?

Kamisawa

2006

J Gastroenterol

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Pancreatic Adenocarcinoma on the Dorsal Part of the Pancreas Divisum Presenting as Acute Recurrent Pancreatitis

Cited by 6 publications

References 10 publications

Carcinoma of the Head of the Pancreas versus Chronic Pancreatitis: Diagnostic Dilemma with Significant Consequences

Carcinoma of the Head of the Pancreas versus Chronic Pancreatitis: Diagnostic Dilemma with Significant Consequences

Kasos galvos vėžio ir lėtinio pankreatito diagnostikos keblumai

Is there a causal relation between pancreas divisum and pancreatic cancer?

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