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Pancreas embryology

Samih Nassif, Cecilia Ponchiardi, Teviah Sachs
Dorsal agenesis of the pancreas (DAP) is an uncommon embryological abnormality where there is absence of the distal pancreas. DAP is mostly asymptomatic, but common presenting symptoms include diabetes mellitus, abdominal pain, pancreatitis, enlarged pancreatic head, and, in a few cases, polysplenia. MRCP and ERCP are the gold standard imaging techniques to demonstrate the absence of the dorsal pancreatic duct. The literature on the association of pancreatic neoplasia and DAP is limited. We present the case of a pancreatic neuroendocrine tumor in a patient with dorsal agenesis of the pancreas, with a review of the related literature...
2016: Case Reports in Gastrointestinal Medicine
Shilpi Agarwal, Babita Pangtey, Neelam Vasudeva
Knowledge of variations in the branching pattern of Celiac Trunk (CT) is important for surgeries of stomach, duodenum, pancreas and hepatobiliary region, for abdominal aortic aneurysm, for liver transplant and chaemoembolization of hepatic tumours. An unusual variation in the branching pattern of CT was observed in 50-year-old male cadaver of Indian origin. CT divided into six branches out of which right & left inferior phrenic arteries originated as first two branches and left gastric artery as the third branch...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Osama S Al Beteddini, Nasir K Amra, Emad Sherkawi
Ciliated foregut cysts are rare anomalies arising from remnants of aberrant embryological development. Around 100 reports on the presence of these congenital masses in the tracheobronchial tree, mediastinum, liver, pancreas and, rarely, the gallbladder have been described. In this article, the case of a 33-year-old woman, who was operated for a laparoscopic cholecystectomy, is presented. During the dissection of the triangle of Calot, a cystic mass, attached to the common hepatic duct, was discovered incidentally...
December 2016: Surgical Case Reports
Jill P Smith, Lionel K Fonkoua, Terry W Moody
The gastrointestinal (GI) peptide gastrin is an important regulator of the release of gastric acid from the stomach parietal cells and it also plays an important role in growth of the gastrointestinal tract. It has become apparent that gastrin and its related peptide cholecystokinin (CCK) are also significantly involved with growth of GI cancers as well as other malignancies through activation of the cholecystokinin-B (CCK-B) receptor. Of interest, gastrin is expressed in the embryologic pancreas but not in the adult pancreas; however, gastrin becomes re-expressed in pancreatic cancer where it stimulates growth of this malignancy by an autocrine mechanism...
2016: International Journal of Biological Sciences
Soichi Narumoto, Ken Hayashi, Hitoshi Seki, Yasuhiro Munakata
BACKGROUND/AIMS: Pancreas-preserving resection of the bile duct has been attempted as an organ preserving procedures for the treatment of low-grade malignant neoplasms of the bile duct. The fact that the lower bile duct penetrates pancreas head to join the duodenum, makes those attempts one of the challenging procedures in biliary tract surgery. Here we present a novel and unique surgical technique for anatomically resecting lower bile duct, focusing on the anatomy of the pancreas head...
May 2015: Hepato-gastroenterology
Mee-Jin Lee, James Salinas, Winny Varikatthas, Ghiyath Alsnih
INTRODUCTION: Ciliated foregut cysts (CFC) are rare anomalies due to aberrant embryological development. It is thought to arise from a remnant of the embryologic foregut. The solitary cysts are characterised by ciliated pseudostratified columnar epithelium. They are usually located above the diaphragm but they can also arise in relation to the liver, gallbladder and pancreas. PRESENTATION OF CASE: We present the first ciliated foregut cyst of the gallbladder case reported in Australia, and the ninth known case to be reported worldwide...
2016: International Journal of Surgery Case Reports
Fabio Rondelli, Walter Bugiantella, Paolo Stella, Marcello Boni, Enrico Mariani, Federico Crusco, Alessandro Sanguinetti, Andrea Polistena, Nicola Avenia
Annular pancreas (AP) in adults is a rare embryologic abnormality detected after development of complications or as incidental finding. Diagnosis and treatment strategies for symptomatic adult AP remain controversial. We describe two different presentation of AP: a woman with a specific upper abdominal pain treated with medical therapy and a man with upper gastroenteric obstructive symptoms which underwent surgical duodeno-jejunal by-pass. English language literature about annular pancreas etiology, diagnosis and treatment was reviewed...
2016: International Journal of Surgery Case Reports
Melissa F Brereton, Elisa Vergari, Quan Zhang, Anne Clark
Islet non-β-cells, the α- δ- and pancreatic polypeptide cells (PP-cells), are important components of islet architecture and intercellular communication. In α-cells, glucagon is found in electron-dense granules; granule exocytosis is calcium-dependent via P/Q-type Ca(2+)-channels, which may be clustered at designated cell membrane sites. Somatostatin-containing δ-cells are neuron-like, creating a network for intra-islet communication. Somatostatin 1-28 and 1-14 have a short bioactive half-life, suggesting inhibitory action via paracrine signaling...
August 2015: Journal of Histochemistry and Cytochemistry: Official Journal of the Histochemistry Society
Shigenori Yamada, Takashi Muraki, Shuichi Yokosawa, Norikazu Arakura, Shigeyuki Kawa, Katsuhiko Ishizaka, Manabu Nakamura
A 52-year-old man was admitted to our hospital complaining of abdominal pain. A blood test showed high serum levels of biliary enzymes and amylase. Surprisingly, a computed tomography scan revealed complete separation of the ventral and dorsal pancreas and swelling of the ventral pancreas with choledocholithiasis. Surgical cholecystectomy was performed to remove the bile duct stones after endoscopic removal was unsuccessful. The complete separation of the pancreatic parenchyma caused by ventral pancreas malrotation seen in this case is extremely rare, and may provide important information regarding embryologic development, deformity, and malfunction of the pancreas...
February 2012: Clinical Journal of Gastroenterology
Takeshi Nishi, Yasunari Kawabata, Noriyoshi Ishikawa, Asuka Araki, Seiji Yano, Riruke Maruyama, Yoshitsugu Tajima
BACKGROUND: Pancreas divisum, the most common congenital anomaly of the pancreas, is caused by failure of the fusion of the ventral and dorsal pancreatic duct systems during embryological development. Although various pancreatic tumors can occur in patients with pancreas divisum, intraductal papillary mucinous neoplasm is rare. CASE PRESENTATION: A 77-year-old woman was referred to our hospital because she was incidentally found to have a cystic tumor in her pancreas at a regular health checkup...
2015: BMC Gastroenterology
E Warner, E Ofo, S Connor, E Odell, J P Jeannon
INTRODUCTION: Thyroglossal duct cysts (TDC) are common midline neck swellings resulting from embryological remnants of the thyroglossal duct. They often contain ectopic thyroid tissue and malignant transformation has been reported, most commonly to papillary thyroid carcinoma. Mucoepidermoid carcinoma (MEC) usually occurs in the salivary glands and only rarely in the thyroid. This is the first case of a MEC occurring within a thyroglossal duct remnant. PRESENTATION OF A CASE: A 73 year old lady presented with a thyroglossal duct cyst...
2015: International Journal of Surgery Case Reports
Christine K C Loo, Tamara N Pereira, Grant A Ramm
Congenital bilateral diaphragm agenesis is a very rare condition. We describe limited (abdomen only) autopsy findings of a case of bilateral diaphragm agenesis in a 27-week male fetus with unusual findings of fibrosis of the pancreatic head and ectopic liver nodules in a mass at the upper abdomen that may represent a possible diaphragm anlage. We have correlated our observations with data from experimental and embryological studies to suggest possible mechanisms for the malformations that were present and their implications for our understanding of pancreas, liver and diaphragm development in the human fetus...
2015: Fetal and Pediatric Pathology
Ramachandra Chowdappa, Vasu Reddy Challa
Pancreatic cancer is associated with poor prognosis and surgery remains the main modality of treatment. Negative resection margin is an important prognostic factor for survival. Retropancreatic margin or the medial margin is the most common site of positive resection margin. Mesopancreas was proposed in analogy with mesorectum, which is considered as a fusion fascia formed embryologically during the development of pancreas. This mesopancreas lies posterior to the pancreas and contains pancreaticoduodenal vessels, lymphatics, nerve plexus and loose areolar tissue...
March 2015: Indian Journal of Surgical Oncology
F Pedica, S Beccari, S Pedron, L Montagna, P Piccoli, C Doglioni, M Chilosi
The homeodomain-containing transcription factor pancreatic duodenal homeobox 1 (PDX-1) plays a key role in pancreatic development and β-cell function. It is a major regulator of transcription in pancreatic cells, and transactivates the insulin gene by binding to a specific DNA motif in its promoter region. Glucose also regulates insulin gene transcription through PDX-1. It has been shown that PDX-1 is required for maintaining pancreatic islet functions by activating gene expression and has a dual role in pancreatic development...
December 2014: Pathologica
Dauren Sarsenov, Mehmet Bülent Tırnaksız, Ahmet Bülent Doğrul, Özlem Tanas, Gökhan Gedikoglu, Osman Abbasoğlu
Heterotopic pancreas is a relatively common variant of foregut embryologic dystopia that can be described as pancreatic tissue found outside the normal anatomic location, being independent from vascular supply of normal pancreas. Having all features of pancreatic tissue except for the major duct structures, this ectopic tissue may be clinically recognized when pathologic changes take place. Inflammation, hemorrhagic or obstructive states, and eventually malignancy-related problems may become a diagnostic challenge for clinician and finally lead to consequences of misdiagnosis...
March 2015: International Surgery
Nadia Peparini
This review highlights the rationale for dissection of the 16a2 and 16b1 paraaortic area during pancreaticoduodenectomy (PD) for carcinoma of the head of the pancreas. Recent advances in surgical anatomy of the mesopancreas indicate that the retropancreatic area is not a single entity with well defined boundaries but an anatomical site of embryological fusion of peritoneal layers, and that continuity exists between the neuro lymphovascular adipose tissues of the retropancreatic and paraaortic areas. Recent advances in surgical pathology and oncology indicate that, in pancreatic head carcinoma, the mesopancreatic resection margin is the primary site for R1 resection, and that epithelial-mesenchymal transition-related processes involved in tumor progression may impact on the prevalence of R1 resection or local recurrence rates after R0 surgery...
March 14, 2015: World Journal of Gastroenterology: WJG
Kim Christin Honselmann, Moritz Pross, Carlo Maria Felix Jung, Ulrich Friedrich Wellner, Steffen Deichmann, Tobias Keck, Dirk Bausch
Pancreatic ductal adenocarcinoma (PDAC) is the fourth most common cause of death from cancer. Its 5-year survival rate is less than 5%. This poor prognosis is mostly due to the cancer's early invasion and metastasis formation, leading to an initial diagnosis at an advanced incurable stage in the majority of patients. The only potentially curative treatment is radical surgical resection. The effect of current chemotherapeutics or radiotherapy is limited. Novel therapeutic strategies are therefore much needed...
January 2015: JOP: Journal of the Pancreas
Manickam Subramanian, Eric Wee, Vijayadwaja Desai, Wilfred C G Peh
A 46-year-old man presented with right loin tenderness following a road traffic accident. Computed tomography and magnetic resonance imaging showed a well-defined, smooth, enhancing oval lesion in the wall of the first part of the duodenum. The lesion was seen separately from the normal pancreas. It showed attenuation, intensity and enhancement similar to that of normal pancreas. Based on the imaging appearance, a diagnosis of ectopic pancreas was made. The patient underwent oesophagogastroduodenoscopy, endoscopic ultrasonography and fine-needle aspiration cytology of the lesion, which confirmed ectopic pancreatic tissue...
December 2014: Singapore Medical Journal
S Louryan, N Vanmuylder
The specimen of which it is a matter here takes part of the heritage of the Museum of Anatomy and Embryology of the Faculty of Medicine of the Université Libre de Bruxelles. Its medical history is completely unknown, because it takes part of an ancient collection of pathological anatomy saved from destruction and recovered by the laboratory of Anatomy and Embryology. The specimen is strongly folded up on itself ("in extension"), its length so arranged is about 25 cm; unfolded, it develops to 45 cm. Cranial perimeter is of 31 cm...
March 2015: Morphologie: Bulletin de L'Association des Anatomistes
Sang-Hoon Ahn, Do Hyun Jung, Sang-Yong Son, Do Joong Park, Hyung-Ho Kim
We developed a novel approach to perform a perfect 11p lymph node dissection (LND), the so-called 'midpancreas mobilization' (MPM) method. Briefly, in pure single-incision laparoscopic distal gastrectomy (SIDG), after the completion of 7, 8a/12a, and 9 LND in the suprapancreatic portion, we started 11p LND after midpancreas mobilization. After mobilization of the entire midpancreas from the white line of Toldt, two gauzes were inserted behind the pancreas. This maneuver facilitated exposure of the splenic vein and complete detachment of soft tissue, including 11p lymph nodes, from the white line of Toldt, which was possible because of the tilting of the pancreas...
November 2014: Annals of Surgical Treatment and Research
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