Embryological development of the pancreas is a complex phenomenon and, therefore, it can have multiple developmental aberrations. Fortunately, the majority of these pancreatic ductal anomalies are asymptomatic with no clinical relevance and are incidentally detected during diagnostic cross-sectional imaging or endoscopic retrograde cholangiopancreatography (ERCP) or autopsy. Occasionally, pancreatic duct anomalies can result in symptoms like abdominal pain or recurrent pancreatitis. Also, an accurate pre-operative diagnosis of ductal anomalies can prevent inadvertent duct injury during surgery. Conventionally, ERCP had been used for an accurate diagnosis of pancreatic duct anomalies. However, because it is invasive and associated with a risk of pancreatitis, it has been replaced with magnetic resonance cholangiopancreatography (MRCP). MRCP has demonstrated high sensitivity and specificity for the diagnosis of ductal anomalies, which can be further improved with the use of secretin-enhanced MRCP. Endoscopic ultrasound (EUS) is a new diagnostic and interventional tool in the armamentarium of endoscopists and has demonstrated promising results in the detection of pancreatic duct variations and anomalies. Along with the visualization of the course and configuration of the pancreatic duct, EUS can also visualize changes in the pancreatic parenchyma, thereby helping with an early diagnosis of any co-existent pancreatic disease. Absence of the stack sign and crossed duct sign are important EUS features to diagnose pancreas divisum. EUS can also help with the diagnosis of other congenital ductal anomalies like annular pancreas, ansa pancreatica, and anomalous pancreaticobiliary union, although the published experience is limited.
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http://dx.doi.org/10.3390/diagnostics13193129 | DOI Listing |
BMC Cancer
December 2024
The Fourth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
Ampullary carcinoma (AC) of the intestinal type represents a distinct variant within the broader category of ampullary neoplasms. The scarcity of pertinent cellular models has constrained investigations centered on this particular malignancy. This research effectively generated a cell line (CL) of intestinal-type AC (DPC-X3).
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Gastroenterology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China.
Rationale: Pancreaticopleural fistula (PPF) is an infrequent etiology of pleural effusion, characterized by nonspecific thoracic symptoms, which often leads to misdiagnosis and subsequent severe complications. Consequently, early diagnosis is crucial for effective management and the prevention of adverse outcomes. This report presents a rare case of PPF causing bilateral pleural effusions, aiming to enhance clinical recognition of this condition.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Hepatobiliary Pancreatic Surgery, Ehime University Graduate School of Medicine, Toon City, Ehime, Japan.
Rationale: Pseudoaneurysm is a potential postoperative complication in hepatobiliary and pancreatic surgery, with catheter-based interventions being the first-line treatment. This study reviews the literature on potential secondary complications following arterial embolization. Additionally, we report a case in which a dislodged embolization coil acted as a nidus for bile duct stone formation, leading to recurrent cholangitis.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Surgery 1, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-Cho, Yoshida-gun, Fukui, 910-1193, Japan.
Background: Type 2 autoimmune pancreatitis is characterized by multiple or segmental strictures of the main pancreatic duct without upstream dilatation. We encountered a case of mass-forming type 2 autoimmune pancreatitis with upstream main pancreatic duct dilatation that was difficult to diagnose preoperatively using endoscopic ultrasound sonography-guided fine-needle aspiration cytology.
Case Presentation: A 58-year-old Japanese man presented with recurrent acute pancreatitis secondary to a 10-mm pancreatic head tumor.
J Surg Oncol
December 2024
Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Background And Objectives: To find the association between preoperative computed tomography (CT) features combined with tumor marker and known high-risk factors of small nonfunctioning pancreatic neuroendocrine tumors (NF-PNETS), thereby selecting appropriate treatment strategy for these patients.
Method: One hundred fourteen patients with NF-PNETs< 20 mm who underwent surgical operation were retrospectively analyzed from 2009 to 2023. Univariate and multivariable logistic regression analyses were performed to find the relationship between preoperative clinical psychological and CT features and high-risk factors.
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