Retroportal main pancreatic duct with circumportal pancreas: radiographic visualization

Gonoi, Wataru; Akahane, Masaaki; Akai, Hiromu; Hagiwara, Kazuchika; Kiryu, Shigeru; Hayashi, Naoto; Ohtomo, Kuni

doi:10.1016/j.clinimag.2011.01.002

Cited by 16 publications

(13 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SWPD is speculated to predispose to pancreatitis [3], but the present results suggest that SWPD does not always induce pancreatitis. Further investigation may explain the cause of santorinicele as a variation in the connection of the ventral and dorsal pancreatic ducts, as suggested in several studies [16,17,19,20], as variable patency of the dorsal pancreatic duct [8-10], or as some unknown congenital factor such as a gene mutation.…”

Section: Discussionmentioning

confidence: 99%

Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundOnly one case of santorinicele without pancreas divisum pathophysiology (SWOPP) was previously reported. The purpose of the study was to determine the gross prevalence of SWOPP and santorinicele with pancreas divisum (SWPD) in community and patient populations, and investigate their clinical and radiographic features.MethodsThis cross-sectional study was performed at a tertiary referral centre. The Patient group comprised 2035 consecutive patients enrolled in the study who underwent magnetic resonance cholangiopancreatography (MRCP) studies. The Community group comprised 2905 consecutive subjects who participated in our whole-body medical check-up program that routinely includes MRCP studies. SWOPP was diagnosed when a saccular dilatation of the terminal portion of the dorsal pancreatic duct was observed unaccompanied by pancreas divisum or dominant dorsal duct. The prevalence of SWOPP and SWPD, and the clinical and radiological features were assessed in each group.ResultsFive cases of SWOPP were found in the Patient group (age range, 67–85 years; mean age, 73.6 years) (5/2035 = 0.25%; 95% confidence interval, 0.07–0.57); there were no cases of SWOPP in the Community group (0/2905 = 0.00%; 95% confidence interval, 0.00–0.10) (P = 0.01). Previous history of pancreatitis (4/5) and chronic pancreatitis (3/5) was more common in patients with SWOPP than in other subjects in the Patient or Community groups (both P < 0.05). Two cases of SWOPP were accompanied by reverse-Z type meandering main pancreatic duct. Six cases of SWPD were found. These cases were asymptomatic in 4/6, had a larger santorinicele (6.9 mm) than SWOPP patients (4.5 mm; P = 0.02), and were not associated with pancreatitis (0/6).ConclusionsThe second to sixth reported cases of SWOPP were presented. SWOPP is a relatively rare condition found mostly in patients suffering pancreatitis, especially chronic pancreatitis, and may be an acquired condition. Santorinicele is not always accompanied by pancreas divisum.

show abstract

Section: Discussionmentioning

confidence: 99%

Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…3). Four retrospective studies, 3 of them combined with case reports 1,4,13 and a published abstract, 8 as well as 16 case reports 2,3,5–7,9–11,14,17,19–23 and 1 letter to the editor 18 were included. All studies were published within the last 25 years (1987–2012).…”

Section: Resultsmentioning

confidence: 99%

“…6 Therefore, more preoperative attention to this anomaly is required. Computed tomography and magnetic resonance imaging are both suitable to identify PAP 3,4,13 (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Portal Annular Pancreas

Harnoss

Diener

et al. 2014

Pancreas

View full text Add to dashboard Cite

Portal annular pancreas (PAP) is an asymptomatic congenital pancreas anomaly, in which portal and/or mesenteric veins are encased by pancreas tissue. The aim of the study was to determine the role of PAP in pancreatic surgery as well as its management and potential complication, specifically, postoperative pancreatic fistula (POPF).On the basis of a case report, the MEDLINE and ISI Web of Science databases were systematically reviewed up to September 2012. All articles describing a case of PAP were considered.In summary, 21 studies with 59 cases were included. The overall prevalence of PAP was 2.4% and the patients' mean (SD) age was 55.9 (16.2) years. The POPF rate in patients with PAP (12 pancreaticoduodenectomies and 3 distal pancreatectomies) was 46.7% (in accordance with the definition of the International Study Group of Pancreatic Surgery).Portal annular pancreas is a quite unattended pancreatic variant with high prevalence and therefore still remains a clinical challenge to avoid postoperative complications. To decrease the risk for POPF, attentive preoperative diagnostics should also focus on PAP. In pancreaticoduodenectomy, a shift of the resection plane to the pancreas tail should be considered; in extensive pancreatectomy, coverage of the pancreatic remnant by the falciform ligament could be a treatment option.

show abstract

“…MMPD is located in the head of the pancreas, where several fusion variations of the ventral and dorsal ducts exist; e.g., AAPB [4], [5], pancreas divisum [5], [6], [7], [8], [23], [24], [25], [31], [32], ansa pancreatica [4], [33], retroportal MPD [34], and other various non-classifiable fusion variants [4], [12], [35], [36], [37]. Of these variants, AAPB [5], pancreas divisum [8], [38], and ansa pancreatica [33], however controversial, have been reported to be associated with pancreatitis and the present results revealed a similar contribution of MMPD and pancreas divisum to the onset of pancreatitis and RAP.…”

Section: Discussionmentioning

confidence: 99%

Meandering Main Pancreatic Duct as a Relevant Factor to the Onset of Idiopathic Recurrent Acute Pancreatitis

et al. 2012

Self Cite

View full text Add to dashboard Cite

BackgroundMeandering main pancreatic duct (MMPD), which comprises loop type and reverse-Z type main pancreatic duct (MPD), has long been discussed its relation to pancreatitis. However, no previous study has investigated its clinical significance. We aimed to determine the non-biased prevalence and the effect of MMPD on idiopathic pancreatitis using non-invasive magnetic resonance (MR) technique.Methods and FindingsA cross-sectional study performed in a tertiary referral center. The study enrolled 504 subjects from the community and 30 patients with idiopathic pancreatitis (7 acute, 13 chronic, and 10 recurrent acute). All subjects underwent MR scanning and medical examination. MMPD was diagnosed when the MPD in the head of pancreas formed two or more extrema in the horizontal direction on coronal images of MR cholangiopancreatography, making a loop or a reverse-Z shaped hairpin curves and not accompanied by other pancreatic ductal anomaly. Statistical comparison was made among groups on the rate of MMPD including loop and reverse-Z subtypes, MR findings, and clinical features. The rate of MMPD was significantly higher for all idiopathic pancreatitis/idiopathic recurrent acute pancreatitis (RAP) (20%/40%; P<0.001/0.0001; odds ratio (OR), 11.1/29.0) than in the community (2.2%) but was not higher for acute/chronic pancreatitis (14%/8%; P = 0.154/0.266). Multiple logistic regression analysis revealed MMPD to be a significant factor that induces pancreatitis/RAP (P<0.0001/0.0001; OR, 4.01/26.2). Loop/reverse-Z subtypes were found more frequently in idiopathic RAP subgroup (20%/20%; P = 0.009/0.007; OR, 20.2/24.2) than in the community (1.2%/1.0%). The other clinical and radiographic features were shown not associated with the onset of pancreatitis.ConclusionsMMPD is a common anatomical variant and might be a relevant factor to the onset of idiopathic RAP.

show abstract

Retroportal main pancreatic duct with circumportal pancreas: radiographic visualization

Cited by 16 publications

References 12 publications

Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations

Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations

Portal Annular Pancreas

Meandering Main Pancreatic Duct as a Relevant Factor to the Onset of Idiopathic Recurrent Acute Pancreatitis

Contact Info

Product

Resources

About