No abstract available.
Early Diagnosis ; Pancreatic Diseases

A comparative descriptive study was carried out on 80 patients diagnosed as pancrea head tumors. Ultrasound results were evaluated through operated and histopathological outcomes. Ultrasound diagnosis reached 96.1% of sensivity and 92.5% of accurracy, concerning the localization of the tumors the accuracy was 68%. Ultrasound sensitivity in the identification of the signs of infiltration in the neighbour tissues, in blood vessels, in gland was 12.5%, 11.8% and 8.8% respectively.
neoplasms ; Pancreatic Diseases ; Pancreatic Neoplasms ; ultrasonography ; diagnosis

Several reports have described the usefulness of tumor markers detected in pancreatic juice for diagnosis of pancreatic cancer. We performed this study to evaluate the usefulness of tumor markers in pure pancreatic juice collected by duodenoscopic cannulation of pancreatic duct before and after injection of secretin. From April 1993 to July 1995, 8 cases of pancreatic cancer, 5 cases of benign pancreatic lesions, and 5 cases of benign biliary diseases without pancreatic lesion were involved. CEA and CA 19-9 immunoreactivity were measured by radioimmunoassay. Concentrations of CA 19-9 in pure pancreatic juice were significantly higher in patients with pancreatic cancer(median value; 3582, range 88.4-10410 IU/ml) than in control patients(median value 231, range 30.4-682 IU/ml)(p<0.05). Concentrations of CEA in pure pancreatic juice were not significantly different between patients with pancreatic cancer(median value: 6,5, range 1.0-152ng/ml) and control patients(median value: 4.0, range 1-17.2 ng/ml)(p>0.05). There was no significant correlation between levels of CA19-9, CEA in pancreatic juice and those levels in serum. The amounts of juice collected by duodenoscopic cannulation in patients with pancreatic cancer were 1.5+/- 0.9ml during 5 minutes before infusion of secretin, 11.3+/- 3.9ml, 10.8+/- 4.0ml, 10.6+/- 4.0ml in 5 minute interval after infusion of secretin. These results indicated that measurement of CA19-9 in pure pancreatic juice may be used as a marker for pancreatic cancer. Adequate amount of pancreatic juice was collected by duodenoscopic cannulation for evaluation of tumor marker, enzyme studies and cytology.
Catheterization ; Diagnosis ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice* ; Pancreatic Neoplasms ; Radioimmunoassay ; Secretin ; Biomarkers, Tumor

This study introduced the signs for identifying the pancreatic lesion due to injuries on films of CT scanner and role of CT scanner in identifying the pancreatic lesion due to close abdominal injuries. In the pancreatic injury, the X-ray and ultrasound only allowed to think of diagnosis and can not identify the lesion of pancreatic parenchyma as well as evaluate the extent of lesion, especially in emergency. When the suspected symptoms occurring, it should implement CT scanner to determine the lesion and timely manage.
Pancreatic Diseases ; Tomography, X-Ray Computed ; Diagnosis

Although the tail of the pancreas is the second most common site of an accessory spleen, intrapancreatic accessory spleen (IPAS) has rarely been noted radiologically. However, as the imaging techniques have recently advanced, IPAS will be more frequently detected as an incidental pancreatic nodule on CT or MRI. Because accessory spleens usually pose no clinical problems, it is important to characterize accessory spleens as noninvasively as possible. An IPAS has similar characteristics to those of the spleen on the precontrast and contrast-enhanced images of all the imaging modalities. In particular, inhomogeneous enhancement of an IPAS in its early phases may be a diagnostic clue. Superparamagnetic iron oxide (SPIO)-enhanced MRI and Levovist-enhanced US, and the mechanisms of which are theoretically similar to that of Tc-99m scintigraphy, can be used as alternative tools to confirm the diagnosis of IPAS. An IPAS shows a significant signal drop similar to the spleen on the SPIO-enhanced T2 or T2*-weighted imaging and prolonged enhancement on the delayed hepatosplenic phase of contrast-enhanced US. We review and illustrate the differential points between IPAS and hypervascular pancreatic tumors in this manuscript.
Choristoma/*diagnosis ; Diagnosis, Differential ; *Diagnostic Imaging ; Humans ; Pancreatic Diseases/*diagnosis ; Pancreatic Neoplasms/diagnosis ; *Spleen

BACKGROUND: The aims of this study were to evaluate the diagnostic value of pancreatic elastase-1(PE-1) in patients with pancreatic diseases and compare the significance of PE-1 with that of pancreatic exocrine function test by pure pancreatic juice (PPJ) collection. METHODS: For evaluation of PE-1, seventy nine patients with pancreatic diseases were examined. For evaluation of exocrine pancreatic function by PPJ, twenty three patients with Chronic pancreatitis(CP) were examined. PPJ was collected by endoscopic cannulation of main pancreatic duct under the intravenous bolus injection of secretin (0.25 CU/kg body weight) and cholecystokinin (CCK, 40 ng/kg body weight). RESULTS: Pancreatic exocrine functions were significantly decreased in patients with CP showing moderate and severe ductal changes on pancreatogram. The mean concentration of fecal PE-1 was significantly decreased in patients with CP and pancreatic cancer, but not in patients with acute pancreatitis. When we analyzed the PE-1 concentration according to Cambridge classification, the concentration of fecal PE-1 was significantly decreased only in patients with moderate and severe CP. With a cut off of 200 ug fecal PE-1/g, the sensitivity of PE-1 was 25%, 60%, and 100%, respectively, for mild, moderate and severe CP, and the specificity was 88.1%. The mean concentration of serum PE-1 was increased both in patients with acute and chronic pancreatitis, but there was no difference between both group. CONCLUSION: Fecal PE-1 is useful for diagnosis of pancreatic exocrine insufficiency in patients with CP, especially in moderate and severe grade of pancreatic exocrine insufficiency. The diagnostic value of fecal PE-1 was also similar to secretin-CCK test in pancreatic exocrine insufficiency.
Catheterization ; Cholecystokinin ; Classification ; Diagnosis ; Humans ; Pancreatic Diseases* ; Pancreatic Ducts ; Pancreatic Juice ; Pancreatic Neoplasms ; Pancreatitis ; Pancreatitis, Chronic ; Secretin ; Sensitivity and Specificity

Santorinicele, a focal cystic dilatation of the distal duct of Santorini, has been suggested as a possible cause of the relative stenosis of the accessory papilla, is associated with complete pancreas divisum, which results in acute episodes of pancreatitis or pain. This report describes a case of a santorinicele, which was initially detected by upper gastrointestinal endoscopy as a polypoid mass, in a patient with recurrent abdominal pain. The mass was subsequently proved to be a santorinicele containing a pancreatic duct stone associated with incomplete pancreas divisum on endoscopic retrograde pancreatography. To the best of our knowledge this is believed to be the first description of a santorinicele associated with these characteristic findings.
Adult ; Calculi/*diagnosis ; Dilatation, Pathologic ; Humans ; Male ; Pancreas/*abnormalities ; Pancreatic Diseases/*diagnosis ; Pancreatic Ducts/*pathology

Background: Injuries to the pancreaticoduodenal complex present a significant challenge both in diagnosis and management. The retroperitoneal location of the pancreas means that it is not a common site of injury, but this also contributes to the difficulty in diagnosis. Objective: To evaluate changes of serum amylase level before the operation of pancreaticoduodenal injuries. Subjects and method: Prospective analysis of 156 patients with pancreaticoduodenal injuries from January 2000 to December 2006 was measured serum amylase level at admission. The factors analyzed in the study included age, gender, time elapsed from injury to admission, type of pancreaticoduodenal injuries according to The American Association for the Surgery of Trauma 1990. Results: The serum amylase level was found to be abnormal in all patients admitted more than 3 hours after trauma. Various comparisons between patients with elevated (78.2%) and nonelevated (26.3%) serum amylase levels showed the statistical significance solely of the time elapsed from injury to admission. The major factor that influenced the serum amylase level on admission appeared to be the time elapsed from injury to admission. Determination of the serum amylase level was no diagnosis within 3 hours or less after trauma, irrespective of the type of injury. Conclusions: To avoid failure in the detection of pancreaticoduodenal injuries, the authors advocate determination of serum amylase levels more than 3 hours after trauma.
Amylases/ diagnostic use ; Duodenal Diseases/ diagnosis ; Pancreatic Ducts/ injuries

Humans ; Hypertension, Portal ; diagnosis ; etiology ; therapy ; Pancreatic Diseases ; complications

Pancreatic ascites and pleural effusion is a rare complication of inflammatory disease of pancreas. Disruption of the pancreatic duct secondary to inflammatory pancreatic disease results in an internal pancreatic fistula into the peritoneal or pleural cavities. Thus, pancreatic secretion through the internal pancreatic fistula accumulate within the peritoneal or pleural cavities. The diagnosis is strongly suspected by paracentesis and thoracentesis, which demonstrate a markedly elevated amylase and an albumin level in pancreatic ascites and pleural effusion, and is confirmed by observation of pancreatic duct contrast leakage at endoscopic retrograde pancreatography. We report a patient with pancreatic ascites and pleural effusion who had no demonstrable pancreatic duct disruption on endoscopic retrograde pancreatography, but successfully treated by pancreatic duct stent endoscopically.
Amylases ; Ascites* ; Diagnosis ; Humans ; Pancreas ; Pancreatic Diseases ; Pancreatic Ducts* ; Pancreatic Fistula ; Pancreatitis, Chronic ; Paracentesis ; Pleural Cavity ; Pleural Effusion* ; Stents*