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pancreatic divisum

Aaron R Kuzel, Muhammad Uzair Lodhi, Mustafa Rahim
Pancreatic divisum is a condition that occurs in 4-14% of the population. Pancreatic divisum occurs in development when the ventral bud and dorsal bud of the pancreas fail to fuse. Patients with this condition are usually asymptomatic, however, 25-38% of these patients experience recurrent pancreatitis that may further progress to chronic pancreatitis. This case is of a 20-year-old female presenting with abdominal pain in the left and right upper quadrants of the abdomen with a significant history of recurrent pancreatitis since the age of seven...
November 17, 2017: Curēus
Jae Ryong Shim, Sang-Jae Park, Hyung Min Park, Eung Chang Lee, Sung-Sik Han
Pancreas divisum-failure of fusion of the dorsal and ventral pancreatic ducts-is relatively well known as the most common congenital anomaly of the pancreatic duct, of with an incidence approximately 10% of all embryos. And there is a rare anomaly similar to pancreas divisum in which doubled ducts are formed. This condition is a rare developmental anomaly called pancreas bifidum or bifid pancreas or fish tail pancreas. This report describes a patient with pancreas bifidum who had 2 separated ducts within the pancreas from tail to neck but did not have a separated parenchyma...
January 2018: Annals of Surgical Treatment and Research
Jianhua Wan, Yaobin Ouyang, Chen Yu, Xiaoyu Yang, Liang Xia, Nonghua Lu
BACKGROUND AND AIMS: Idiopathic acute pancreatitis (IAP) poses a diagnostic challenge for gastroenterologists, because confirmation of the disease etiology has important implications for the selection of the best possible treatment and the prevention of possible recurrence or the development of chronic pancreatitis (CP). ERCP, EUS, and MRCP typically are used to diagnose IAP when conventional radiologic methods fail. However, their exact role in the diagnosis of IAP has not yet been determined...
December 7, 2017: Gastrointestinal Endoscopy
Sumit Kumar Singh, Anshu Srivastava, Praveer Rai, Surender K Yachha, Ujjal Poddar
OBJECTIVES: Endoscopic ultrasound (EUS) is an established tool for evaluation of adults with acute recurrent pancreatitis (ARP) whereas data in pediatrics is limited. Our study assessed the role of EUS in identifying etiology including changes of chronic pancreatitis (CP) in children and adolescents with ARP. METHODS: Children with ARP (≥2 episodes of acute pancreatitis [AP]) were prospectively evaluated with a detailed clinical proforma and EUS. Subjects with known etiology of ARP or CP on ultrasonography/computed tomography and magnetic resonance cholangiopancreatography (MRCP, Cambridge grade ≥3) were excluded...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
Qi-Shan Zeng, Chun-Cheng Wu, Wei Liu, Lian-Song Ye, Shan Jiang, Yu-Hang Zhang, Bing Hu
No abstract text is available yet for this article.
December 2017: American Journal of Gastroenterology
Tanyaporn Chantarojanasiri, Hiroyuki Isayama, Yousuke Nakai, Saburo Matsubara, Natsuyo Yamamoto, Naminatsu Takahara, Suguru Mizuno, Tsuyoshi Hamada, Hirofumi Kogure, Kazuhiko Koike
Background/Aims: Groove pancreatitis (GP) is an uncommon disease involving the pancreaticoduodenal area. Possible pathogenesis includes obstructive pancreatitis in the duct of Santorini and impaired communication with the duct of Wirsung, minor papilla stenosis, and leakage causing inflammation. Limited data regarding endoscopic treatment have been published. Methods: Seven patients with GP receiving endoscopic treatment were reviewed. The morphology of the pancreatic duct was evaluated by a pancreatogram...
March 15, 2018: Gut and Liver
Wouter J Vinck, Frank Van de Mierop, François Van Mieghem, Maarten Vinck, Herman Becq, Geneviève Michils
We first describe a patient with multiple endocrine neoplasia type 1 (MEN1) and dorsal pancreatic hemi-agenesis. Previously, pancreas divisum has been reported in MEN1. Recent data in mice have elucidated the molecular mechanisms of pancreatic endoderm specification. Disinhibition of hedgehog signaling appears to be important in how Gata4 and Gata6 variants cause pancreatic agenesis. Disinhibition of hedgehog signaling has also been observed in Men1 knockout pancreatic islets. Although we cannot exclude a spurious association between dorsal pancreatic hemi-agenesis and MEN1 in our patient, we argue that developmental abnormalities of the pancreas may have to be considered as possibly related to the MEN1 phenotype...
November 23, 2017: European Journal of Medical Genetics
Sergio López-Durán, Celia Zaera, Juan Ángel González-Martín, José Ramón Foruny, Agustín Albillos, Enrique Vázquez-Sequeiros
Endoscopic treatment of pancreatic ductal malformations causing recurrent acute pancreatitis, such as pancreas divisum or ansa pancreatica, is mainly based on the sphincterotomy of the minor papilla. However, the technical complexity of conventional endoscopic retrograde cholangiopancreatography (ERCP) is increased in patients presenting anatomical variants like these and it may be unsuccessful. We report the case of a pancreas divisum combined with ansa pancreatica and describe the cannulation and sphincterotomy of the minor papilla using an ultrasound-assisted Rendez-Vous technique...
November 2017: Revista Española de Enfermedades Digestivas
Abimbola Adike, Bara I El Kurdi, Sathvika Gaddam, Heidi E Kosiorek, Norio Fukami, Douglas O Faigel, Joseph M Collins, Francisco C Ramirez
No abstract text is available yet for this article.
November 2017: Pancreas
Yan-Lin Li, Man-Leung Yu, Kam-Ho Lee
Pancreas divisum is a common variation in pancreatic ductal anatomy present in up to 10% of the population with variable clinical importance. The crossing duct sign refers to the appearance of dominant dorsal duct crossing the intrapancreatic common bile duct to empty into the minor papilla, best illustrated on maximum intensity projection images from MRCP.
September 4, 2017: Abdominal Radiology
Lamprinos Michailidis, Bilal Aslam, Alla Grigorian, Houssam Mardini
BACKGROUND: The purpose of this study was to perform a meta-analysis assessing the efficacy and predictors of success of endoscopic therapy in the management of patients with pancreas divisum. METHODS: An electronic database search (PubMed and ScienceDirect) was performed for relevant studies. Studies were selected based on predefined criteria and data were extracted on patient population, follow up, endotherapy methods, success rates and complication rates. A random-effect model was used to pool the effect size across studies...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Bin Cheng, Demin Li, Xiaoli Wu, Zhicheng Zhang, Min Zhang, Min Yang, Qiaozhen Guo, Qiu Zhao
No abstract text is available yet for this article.
July 6, 2017: Endoscopic Ultrasound
Yong Hyeok Choi, Soon Man Yoon, Eun Bee Kim, Youngmin Oh, Keunmo Kim, Jisun Lee, Seon Mee Park, Sei Jin Youn
Peptic ulcer bleeding is treated using endoscopic hemostasis using clips or bands. Pancreas divisum (PD), a congenital anomaly of the pancreas, usually has no clinical symptoms; however, pancreatitis may occur if there are disturbances in the drainage of pancreatic secretions. We report an unusual case of PD accompanied by acute pancreatitis, following endoscopic band ligation for duodenal ulcer bleeding. A 48-year-old woman was admitted to our hospital due to melena. An upper endoscopy revealed a small ulcer with oozing adjacent minor papilla...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Jiri Snajdauf, Ondrej Petru, Jiri Nahlovsky, Michal Rygl, Barbora Frybova, Jiri Bronsky, Vladimir Mixa, Radan Keil
Introduction  A retrospective study was performed to evaluate the clinical features, diagnostic methods, and treatment alternatives in children with pancreas divisum (PD). Materials and Methods  Patients who underwent treatment for PD between 1999 and 2014 at our department were evaluated for sex, age, presenting symptoms, physical examination findings, biochemical markers, diagnostic methods, treatment modalities, and results of treatment during follow-up. Results  Seven patients who underwent treatment of symptomatic PD were included in the study...
March 29, 2017: European Journal of Pediatric Surgery
Ujjal Poddar, Surender K Yachha, Vibhor Borkar, Anshu Srivastava
BACKGROUND/AIMS: In view of paucity of literature we analyzed our experience of acute recurrent pancreatitis (ARP) to study clinical profile and long-term outcome. METHODS: Over 13 years, 93 consecutive children (≤18 years) diagnosed to have ARP were included in this study. Magnetic resonance cholangiopancreatography was done at baseline and on follow-up. Common mutations for serine-protease-inhibitor (SPINK1 N34S), protease inhibitor (PRSS1 R122S) and cystic fibrosis transmembrane conductance regulator (CFTR deltaF508, 5T) were studied in 22 idiopathic cases...
July 2017: Digestive and Liver Disease
Adrián Ransom-Rodríguez, Ruben Blachman-Braun, Emilio Sánchez-García Ramos, Jesús Varela-Prieto, Erick Rosas-Lezama, Miguel Ángel Mercado
Choledochal cysts are rare congenital malformations of the bile duct characterized by dilatations of the intrahepatic and/or extrahepatic portion of the biliary tree, they are associated to an anomalous arrangement of the pancreaticobiliary duct. Pancreas divisum results from a fusion failure of the pancreatic buds. The coexistence of pancreas divisum and choledochal cyst in adults has been reported in less than 10 well documented cases. This article presents a case of a 42-year-old Peruvian man with intermittent episodes of abdominal pain, initially diagnosed with choledocholithiasis, who underwent open cholecystectomy...
February 2017: Annals of Hepato-Biliary-Pancreatic Surgery
Radhika Chavan, Rakesh Kalapala, Zaheer Nabi, Sundeep Lakhtakia, D Nageshwar Reddy
No abstract text is available yet for this article.
February 2017: Endoscopy
Caleb J Fan, Kenzo Hirose, Christi M Walsh, Michael Quartuccio, Niraj M Desai, Vikesh K Singh, Rita R Kalyani, Daniel S Warren, Zhaoli Sun, Marie N Hanna, Martin A Makary
Importance: Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective: To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants: Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015...
June 1, 2017: JAMA Surgery
Jordan D Rosen, Rebecca S Lane, Jose M Martinez, Eduardo A Perez, Jun Tashiro, Amy E Wagenaar, Robert M Van Haren, Ashwini Kumar, Juan E Sola
PURPOSE: Despite its diagnostic and therapeutic utility, endoscopic retrograde cholangiopancreatography (ERCP) is underutilized in children. METHODS: Patients younger than 18years undergoing ERCP from 2000 to 2014 at a children's hospital were identified. Patient characteristics and outcomes were evaluated. RESULTS: Overall, 215 ERCPs (78% therapeutic) were performed in 184 patients. Our cohort was 67% female, with a median age (IQR) of 14 (8) years...
July 2017: Journal of Pediatric Surgery
Atsushi Nanashima, Naoya Imamura, Yuki Tsuchimochi, Takeomi Hamada, Kouichi Yano, Masahide Hiyoshi, Yoshiro Fujii, Fumiaki Kawano, MitsuruTamura
INTRODUCTION: This case report is intended to inform acute care surgeons about treating rare horizontal laceration of the pancreas head caused by blunt trauma. CASE PRESENTATION: A 57-year-old woman who sustained blunt abdominal trauma during a car crash was transported to the emergency center of our hospital with unstable vital signs due to hemorrhagic shock. Computed tomography showed transection of the pancreas head and massive intra-abdominal hemorrhage. She was referred for emergency surgery because of a transient response...
2017: International Journal of Surgery Case Reports
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