Pancreatic Diseases

Ueno, Eiko; Takada, Yukari; Yoshida, Izumi; Toda, Joe; Sugiura, Toshihiro; Toki, Fumitake

doi:10.1097/00006676-199804000-00034

Cited by 56 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging modality reported 50–70% sensitivity for the diagnosis of PD with [ 1 ]. Ueno et al compared MRCP with ERCP in 97 patients and concluded that MRCP could better demonstrate the normal pancreatic duct and various pancreatic duct abnormalities [ 26 ]. PD was detected using MRCP in four of the eight patients (50%) in this series.…”

Section: Discussionmentioning

confidence: 99%

A possible manifestation of pancreas divisum–pancreatic pseudocyst in an infant with no apparent history of pancreatitis: a case report

Baba,

Yamazaki,

Sakai

et al. 2023

surg case rep

View full text Add to dashboard Cite

Background Pancreas divisum (PD), the most common pancreatic anomaly, is caused by the failure of pancreatic bud fusion in the embryo. Although most cases are asymptomatic, it can cause pancreatitis or epigastric pain. We report an unusual case of PD in an infant. Case presentation The patient was a 9-month-old girl with no pertinent medical history. She had suffered vomiting and diarrhea for 1 week before transfer to our hospital. Her general condition was poor, and abdominal distention was noted. Blood tests revealed microcytic anemia with normal chemical markers. The parents reported no episode of pancreatitis. Ultrasonography revealed massive ascites, which was later found to be bloody. Enhanced computed tomography and magnetic resonance imaging depicted a cystic lesion, approximately 2 cm in size, anterior to the second portion of the duodenum. During exploratory laparotomy, a pinhole was identified on the cyst wall, which was mistakenly identified as a duodenal perforation, and direct closure was performed. Postoperative levels of serum amylase and inflammation markers were elevated, and the amount of ascites increased, impairing oral feeding. The level of pancreatic enzymes in the ascites was high. Imaging studies were repeated, but the cause of pancreatic fistula was not identified. Conservative therapy, including administration of total parenteral nutrition, antibiotics, and octreotide, was initiated, but the situation did not improve. Three months after admission, endoscopic retrograde cholangiopancreatography showed a thick dorsal pancreatic duct communicating with a hypoplastic ventral duct, which was indicative of PD. Contrast medium leaking from the dorsal duct near the minor ampulla revealed the presence of a pseudocyst. Stenting via the minor papilla was impossible because the minor papilla was obstructed. Instead, a stent was inserted into the ventral pancreatic duct. Endoscopic transgastric drainage of the cyst was effective, and the patient was discharged, 7 months after admission. The patient is healthy, but the gastric stent needs to be replaced regularly. Conclusion In children, PD can manifest with pancreatic pseudocyst that causes pancreatic ascites, even in the absence of pancreatitis. This may be a previously unrecognized manifestation of PD in children, and clinicians need to be aware of it.

show abstract

Section: Discussionmentioning

confidence: 99%

A possible manifestation of pancreas divisum–pancreatic pseudocyst in an infant with no apparent history of pancreatitis: a case report

Baba,

Yamazaki,

Sakai

et al. 2023

surg case rep

View full text Add to dashboard Cite

show abstract

“…In an older study by Bret et al, MRCP was able to detect PD in all patients that were diagnosed with PD in ERCP [19]. In another older study by Ueno et al, sensitivity of MRCP for PD diagnosis was below 50% [20]. Newer studies report on sensitivities of MRCP for PD diagnosis that lie in between of these values, e.g.…”

Section: Discussionmentioning

confidence: 99%

Is MRCP necessary to diagnose pancreas divisum?

et al. 2019

View full text Add to dashboard Cite

Background The purpose of this study is to compare the performance of three-dimensional magnetic resonance cholangiopancreatography (3D-MRCP) with non-MRCP T2-weighted magnetic resonance imaging (MRI) sequences for diagnosis of pancreas divisum (PD). Methods This is a retrospective study of 342 consecutive patients with abdominal MRI including 3D-MRCP. 3D-MRCP was a coronal respiration-navigated T2-weighted sequence with 1.5 mm slice thickness. Non-MRCP T2-weighted sequences were (1) a coronal inversion recovery sequence (TIRM) with 6 mm slice thickness and (2) a transverse single shot turbo spin echo sequence (HASTE) with 4 mm slice thickness. For 3D-MRCP, TIRM, and HASTE, presence of PD and assessment of evaluability were determined in a randomized manner. A consensus read by two radiologists using 3D-MRCP, non-MRCP T2-weighted sequences, and other available imaging sequences served as reference standard for diagnosis of PD. Statistical analysis included performance analysis of 3D-MRCP, TIRM, and HASTE and testing for noninferiority of non-MRCP T2-weighted sequences compared with 3D-MRCP. Results Thirty-three of 342 patients (9.7%) were diagnosed with PD using the reference standard. Sensitivity/specificity of 3D-MRCP for detecting PD were 81.2%/69.7% ( p < 0.001). Sensitivity/specificity of TIRM and HASTE were 92.5%/93.9 and 98.1%/97.0%, respectively (p < 0.001 each). Grouped sensitivity/specificity of non-MRCP T2-weighted sequences were 99.8%/91.0%. Non-MRCP T2-weighted sequences were non-inferior to 3D-MRCP alone for diagnosis of PD. 20.2, 7.3%, and 2.3% of 3D-MRCP, TIRM, and HASTE, respectively, were not evaluable due to motion artifacts or insufficient duct depiction. Conclusions Non-MRCP T2-weighted MRI sequences offer high performance for diagnosis of PD and are noninferior to 3D-MRCP alone. Trial registration Not applicable.

show abstract

“…Additionally, when mucin or tumor occupies the entire SD, no image of SD is seen, as occurred in one of our cases. On the other hand, MRCP generates precise information about the anatomy of the pancreatic ducts and branches and can differentiate retained mucin from the tumors, both of which produce defects on pancreatography [12].…”

Section: Discussionmentioning

confidence: 99%

Intraductal Papillary‐mucinous Tumors Arising in Santorini’s Duct: Clinicopathologic Features and the Treatment of Choice

et al. 2005

View full text Add to dashboard Cite

Almost all reported cases of intraductal papillary-mucinous tumors of the pancreas (IPMTs) originate from Wirsung's duct (WD), the main pancreatic duct, or their branches. IPMTs arising from Santorini's duct (SD) and its branches have rarely been reported. This article presents the clinicopathologic features of IPMTs originating in SD and its branches. Of 36 IPMTs resected in our institution, 5 originated in the region of SD: 3 in SD and 2 from its branches. Both SD and WD were dilated in all cases on radiographic and ultrasonographic studies. The maximum diameter of SD, determined by computed tomography or ultrasonography, was larger than that of WD in all cases. Seven reports of IPMT arising from SD have been published. Four lesions originated from SD and the others from its branches. Overall, 9 of 12 lesions (75%) were considered malignant. In conclusion, the coexistence of an IPMT and a dilated SD suggests an origin in the SD. These tumors have a high malignant potential and should be excised.

show abstract

Pancreatic Diseases

Cited by 56 publications

References 0 publications

A possible manifestation of pancreas divisum–pancreatic pseudocyst in an infant with no apparent history of pancreatitis: a case report

A possible manifestation of pancreas divisum–pancreatic pseudocyst in an infant with no apparent history of pancreatitis: a case report

Is MRCP necessary to diagnose pancreas divisum?

Intraductal Papillary‐mucinous Tumors Arising in Santorini’s Duct: Clinicopathologic Features and the Treatment of Choice

Contact Info

Product

Resources

About