In assessing new minimally invasive diagnostic techniques (duct endoscopy) and therapy (lithotripsy) of salivary gland disease, it is of importance to know the true dimensions of the secretory ducts. Twenty-five ducts of the parotid gland and 20 ducts of the sub-mandibular gland were examined histologically at different points of their anatomic course and their in vivo diameters were evaluated using a previously determined formalin-induced shrinking factor. The mean diameter of Stensen's duct at four different points along its length ranged between 0.5 mm and 1.4 mm, depending on the site. A narrowing at the middle of the duct was striking. In all preparations examined, the minimum width of the secretory duct was located at the ostium. In Wharton's duct the narrowest duct diameter was also identified at the ostium. The mean values for the duct diameters ranged between 0.5 mm and 1.5 mm. For diagnostic and therapeutic purposes, endoscopes, balloon catheters and stone-extraction baskets should conform as much as possible to physiological duct widths. A diameter of 1.2 mm should be considered the upper limit for duct instruments. Our findings also suggest that in the case of salivary stone lithotripsy the best results will be achieved when the maximum size of a stone fragment does not exceed 1.2 mm.
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http://dx.doi.org/10.1007/s001060050345 | DOI Listing |
J Surg Case Rep
January 2025
Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco.
We present a pioneering case of a duplication of the common bile duct associated with agenesis of the dorsal pancreas in a 66-year-old man. After an episode of cholestatic jaundice, radiological investigations revealed complex vascular and biliary anomalies, redefining the therapeutic strategy. Instead of risky surgery, endoscopic biliopancreatic drainage resolved the symptoms.
View Article and Find Full Text PDFBackground And Aim: Managing benign biliary stricture endoscopically is complicated and challenging. This study aimed to evaluate the safety and efficacy of a 6-month placement of a fully covered self-expanding metallic stent for refractory benign biliary stricture.
Methods: Twenty-two patients with refractory benign biliary stricture (13 with chronic pancreatitis and 9 without) were recruited from five higher tertiary care centers.
Cureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFCureus
December 2024
Pediatric Surgery, Combined Military Hospital Lahore, Lahore, PAK.
Umbilical lesions in children represent a wide spectrum of congenital or acquired anomalies. Congenital anomalies are mainly because of failed obliteration of the omphalomesenteric duct while acquired pathologies are either because of delayed umbilical cord separation causing umbilical granuloma or result from umbilical stump infection producing omphalitis with persistent discharge. Meckel's diverticulum is considered the most common gastrointestinal congenital anomaly resulting from obliteration failure of the omphalomesenteric duct while umbilical granuloma is a common acquired umbilical lesion seen in daily practice.
View Article and Find Full Text PDFUrol Case Rep
January 2025
Department of Urology, China Medical University Hospital, Taiwan.
Zinner syndrome is a congenital anomaly characterized by seminal vesicle cysts, ipsilateral renal agenesis, and ejaculatory duct obstruction possibly associated with infertility. Only 200 cases of Zinner syndrome have been reported since its discovery in 1914. We present the case of a 63-year-old man seeking treatment for a ureteropelvic junction stone causing severe hydronephrosis.
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