Ultrasonic visualization of Wirsung's duct: Dream or reality?

Abstract

Ultrasonic visualization of normal and pathological Wirsung's ducts has become quite common, especially with the newest gray scale units. Ductal images were studied in 17 cases of quiescent chronic pancreatitis. Duct dilatation could be identified in the majority. Indexing WordsWirsung's Duct Ultrasound Chronic Pancreatitis Wirsung's Duct DilatationAs ultrasonic techniques become more reliable and resolution improves, the pancreas can be displayed more consistently and outlined more sharply. The mesenteric vessels, the splenic vein (Figs. 1-3)' the splenoportal junction, and the portal vein are commonly seen on pancreatic scans ('1-6). The common bile duct can also be visualized above and inside the head of the pancreas (6). It is then logical that we should also expect t o visualize Wirsung's duct.In a preliminary report (7), we showed that Wirsung's duct could be displayed under certain conditions. In fact, as early as 1975, Burger (8) had published a transverse scan of the pancreas, displaying a longitudinal section of an enlarged Wirsung's duct. Gosink and Leopold (9) recently published several ultrasonic scans of a dilated Wirsung's duct.

Pancreatic duct diameter: Sonographic measurement in normal subjects

“…P a r~l e k a r ,~ in his prospective study designed to measure the normal duct in 100 cases, concluded that 1.3 mm was the mean value with 0.6-2.6 mm being the extreme values. He felt Eisenscher and Weill (1979) Weinsteins ( that the 2-mm value reported previously was due to the fact that the study was retrospective. Only three of his patients had values in this range.…”

Sonographic evaluation of the pancreatic duct in normal children and children with pancreatitis.

“…Our study was age-matched regarding normal caliber of pancreatic duct in children. Unlike some adult sonographic studies of the pancreatic duct, [8][9][10][11][12][13][14][15] we chose to measure the pancreatic duct in a way that included the anterior and posterior walls because the lumen diameter of the pancreatic duct in infants and children has a smaller diameter than that in adults. This way of measuring can decrease the bias of measurement.…”

“…noninvasive and readily available method for evaluation of pancreatic disease, and it has achieved a high success rate in demonstrating the pancreatic duct in the patients with pancreatic disease as well as in normal children. [8][9][10][11][12][13][14][15][16] Several previous reports have documented the diameter of pancreatic duct in adults, [9][10][11][12][13][14][15][16][17][18][19][20] but the diameter in children was seldom reported. In the present study, we used ultrasonography to evaluate the diameters of the pancreatic duct in children with pancreatitis and in normal children.…”