1.Santorinicele Containing a Pancreatic Duct Stone in a Patient with Incomplete Pancreas Divisum.
Kwang Ro JOO ; Sung Jo BANG ; Jung Woo SHIN ; Do Ha KIM ; Neung Hwa PARK
Yonsei Medical Journal 2004;45(5):952-955
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
2.Congenital Variants and Anomalies of the Pancreas and Pancreatic Duct: Imaging by Magnetic Resonance Cholangiopancreaticography and Multidetector Computed Tomography.
Aysel TURKVATAN ; Ayse ERDEN ; Mehmet Akif TURKOGLU ; Ozlem YENER
Korean Journal of Radiology 2013;14(6):905-913
Though congenital anomalies of the pancreas and pancreatic duct are relatively uncommon and they are often discovered as an incidental finding in asymptomatic patients, some of these anomalies may lead to various clinical symptoms such as recurrent abdominal pain, nausea and vomiting. Recognition of these anomalies is important because these anomalies may be a surgically correctable cause of recurrent pancreatitis or the cause of gastric outlet obstruction. An awareness of these anomalies may help in surgical planning and prevent inadvertent ductal injury. The purpose of this article is to review normal pancreatic embryology, the appearance of ductal anatomic variants and developmental anomalies of the pancreas, with emphasis on magnetic resonance cholangiopancreaticography and multidetector computed tomography.
Cholangiopancreatography, Magnetic Resonance/*methods
;
Humans
;
Multidetector Computed Tomography/*methods
;
Pancreas/abnormalities
;
Pancreatic Diseases/congenital/pathology/radiography
;
Pancreatic Ducts/*abnormalities
3.Choledochal cyst associated the with anomalous union of pancreaticobiliary duct (AUPBD) has a more grave clinical course than choledochal cyst alone.
Hye Kyoung SONG ; Myung Hwan KIM ; Seung Jae MYUNG ; Sung Koo LEE ; Hong Ja KIM ; Kyo Sang YOO ; Dong Wan SEO ; Hyun Joo LEE ; Byeong Cheol LIM ; Young Il MIN
The Korean Journal of Internal Medicine 1999;14(2):1-8
OBJECTIVE: Since choledochal cyst is frequently associated with the anomalous union of pancreaticobiliary duct (AUPBD), AUPBD has been regarded to be the etiologic factor of choledochal cyst. However, the clinical significance of AUPBD an patients with choledochal cyst has not been clearly defined. Therefore, to clarify the significance of AUPBD in choledochal cyst patients, we compared the clinical features of patients with choledochal cyst according to the presence or absence of AUPBD. METHODS: Among 52 cases which were diagnosed as choledochal cyst out of 5,037 ERCP referrals between August 1990 and December 1996, we selected 44 cases, in which the pancreaticobiliary junction was clearly visualized on cholangio-pancreaticography. These cases were divided into AUPBD-present group (n = 28) and AUPBD-absent group (n = 16). Clinical features were compared between the two groups. Furthermore, in AUPBD-present group, clinical data were also analyzed according to Kimura's classification of AUPBD. RESULTS: In our study, AUPBD was associated with choledochal cyst in 28 (64%) cases. AUPBD was found only in type I and IV according to Todani's classification of choledochal cyst. There were no significant differences between the AUPBD-present group and the AUPBD-absent group in the incidence of gallstone disease, while the incidence of acute inflammation was 93% (26/28) in the AUPBD-absent group (p < 0.01). Carcinoma developed only in the AUOBD-present group (9/28, 32%) (p < 0.05). Pancreatic disorders (i.e. pancreatic stone, pancreatitis or pancreatic cancer) occurred in 12 of 28 cases in the AUPBD-present group (43%), while only in 1 of 16 cases in the AUPBD-absent group (6%) (p < 0.05). CONCLUSION: AUPBD associated with choledochal cyst may have implications not only as a possible etiologic factor but also as an important factor that may affect the clinical course, surgical planning and prognosis. In cases with choledochal cyst, we should make an effort to evaluate the presence of AUPBD.
Adolescence
;
Adult
;
Aged
;
Bile Ducts/abnormalities*
;
Calculi/complications
;
Cholangiography
;
Choledochal Cyst/radiography
;
Choledochal Cyst/pathology
;
Choledochal Cyst/complications*
;
Female
;
Human
;
Inflammation/complications
;
Male
;
Middle Age
;
Neoplasms/complications
;
Pancreatic Ducts/radiography
;
Pancreatic Ducts/abnormalities*
;
Prognosis
4.Clinical Features of Neuroendocrine Tumor of the Pancreas: Single Center Study.
Tae Wook KANG ; Kyu Taek LEE ; Min Kyu RYU ; Won MOON ; Sang Soo LEE ; Sun Young LEE ; Ji Young HWANG ; Jong Kyun LEE ; Jin Seok HEO ; Seong Ho CHOI ; Sang Heum KIM ; Seung Woon PAIK ; Jong Chul RHEE
The Korean Journal of Gastroenterology 2006;48(2):112-118
BACKGROUND/AIMS: Pancreatic neuroendocrine tumors (PNET) are rare and manifest as functioning tumor (FT) or non-functioning tumor (NFT). Although malignant changes are observed in some cases, its prognosis is better than pancreatic cancer. We evaluated clinicoradiologic features and prognosis of FT and NFT. In addition, we tried to find the predictive factors for the recurrence of NFT after resection. METHODS: Between October 1994 and June 2004, we retrospectively evaluated the clinicopathologic features and prognosis of 12 cases of FT and 31 cases of NFT diagnosed by surgical pathology at single medical center in Korea. RESULTS: PNET included 6 insulinomas, 4 gastrinomas, 1 glucagonoma, 1 somatostatinoma and 31 NFT. The major clinical manifestations were neuroglycopenic symptoms (100%) in insulinoma, abdominal ulcer symptoms (75%) in gastrinoma, dermatitis (100%) in glucagonoma, steatorrhea (100%) in somatostatinoma, and abdominal discomfort or pain (45%) in NFT. NFT was located more proximally when compared to FT (p=0.023). NFT showed more malignant (64.5%) behavior compared to FT (41.7%) despite the lack of statistical significance. Curative resections were done without postoperative death in 38 cases. Six cases of NFT (21.4%) and 1 case of FT (10%) recurred with an average of 26.5 months. In the recurrent NFT, the findings of diabetes mellitus (p=0.010), abnormal pancreatic duct (p=0.026), Whipple's operation (p=0.013) and tumor emboli (p=0.03) were more common than in non-recurrent NFT. CONCLUSIONS: FT and NFT showed different clinicoradiologic features. In addition, NFT should be monitored more carefully because of frequent recurrence.
Adult
;
Diabetes Mellitus/pathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Neoplastic Cells, Circulating/pathology
;
Neuroendocrine Tumors/complications/*diagnosis
;
Pancreatic Ducts/abnormalities/pathology
;
Pancreatic Neoplasms/complications/*diagnosis
;
Whipple Disease/complications
5.A Case of the Pancreatic Duct Change after a Long-term Pancreatic Stenting in Pancreas Divisum and the Fine Structural Analysis of Occluded Pancreatic Polyethylene Stent.
Jai Hoon YOON ; Ho Soon CHOI ; Sang Hyeon BAEG ; Oh Young LEE ; Byung Chul YOON ; Jung Kyun KWON ; Won Kyu KIM
The Korean Journal of Gastroenterology 2006;47(2):153-158
The pancreatic duct stenting is now recognized as the treatment option for a number of pancreatic disorders. Although the stent-induced ductal changes may result, there is little information regarding the frequency of these stent-induced changes in chronic pancreatitis. Pancreatic stents may occlude with time, but there is only little information available on the nature of the clogging process. Although a short-term efficacy of endoscopic pancreatic duct stenting has been proved, the long-term efficacy continues to be controversial. The aim of this study was to report a case of chronic pancreatitis with pancreatolith after the incidental long-term pancreatic stenting for 3 years due to a pancreas divisum with acute pancreatitis. Also, this study described the analysis of the ultrastructural changes in the surface of an occluded pancreatic stent. A scanning and transmission electron microscopy showed an amorphous protein matrix in whole stent that arranged as a network in some areas but arranged as the layers in other areas. A variable number of bacteria of mixed species, calcium carbonate or calcium oxalate crystal, round leukocyte were scattered in the protein matrix. The yeast and plant material were seen in some part of the stent as well.
Cholangiopancreatography, Endoscopic Retrograde
;
Humans
;
Lithiasis/etiology
;
Male
;
Middle Aged
;
Pancreas/*abnormalities
;
Pancreatic Ducts/*pathology
;
Pancreatitis/complications/*therapy
;
*Polyethylene
;
Stents/*adverse effects
6.The experimental study of hepatic injuries induced by anomalous pancreaticobiliary ductal union.
Feng CHEN ; Jian WANG ; Shun-Gen HUANG ; Xing-Dong WANG ; Yi LV
Chinese Journal of Hepatology 2009;17(3):231-232
Animals
;
Biliary Tract
;
abnormalities
;
diagnostic imaging
;
Cats
;
Cholangiography
;
Disease Models, Animal
;
Female
;
Liver
;
metabolism
;
pathology
;
Liver Diseases
;
diagnostic imaging
;
etiology
;
metabolism
;
Male
;
Malondialdehyde
;
metabolism
;
Mitochondria, Liver
;
diagnostic imaging
;
pathology
;
Pancreatic Ducts
;
abnormalities
;
diagnostic imaging