1/8. Impacted papilla minor stone in pancreas divisum causing severe acute pancreatitis: a case for early ERCP in acute pancreatitis of unknown origin.This is the first description of severe acute pancreatitis in pancreas divisum caused by a solitary stone impacted in the minor papilla. Recovery was rapid after diagnostic endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic stone removal. Since other etiological factors accounting for the acute pancreatitis were carefully excluded, it seems that obstruction of the minor papilla by a solitary pancreatic concrement was the most likely cause of acute pancreatitis. This case report demonstrates the diagnostic importance of early ERCP in cases of etiologically unexplained acute pancreatitis.- - - - - - - - - - ranking = 1keywords = papilla (Clic here for more details about this article) |
2/8. Anomalous pancreaticobiliary union and chronic pancreatitis: rare presentation with biliary peritonitis.Anomalous pancreaticobiliary union (APBU) has varied presentations. We report the case of a 12-year-old female who presented with biliary peritonitis due to a perforation of the common bile duct due to impaction of a pancreatic calculus at the duodenal papilla. She had a long common-biliary channel and pancreas divisum with chronic calcific pancreatitis involving the pancreatic head and neck. To our knowledge, this is the first such reported case in the literature.- - - - - - - - - - ranking = 0.16666666666667keywords = papilla (Clic here for more details about this article) |
3/8. Santorinicele containing a pancreatic duct stone in a patient with incomplete pancreas divisum.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.- - - - - - - - - - ranking = 0.16666666666667keywords = papilla (Clic here for more details about this article) |
4/8. The role of the accessory pancreatic duct of Santorini in pancreatic drainage in children (with emphasis on choledochal cyst patients).Pancreatic drainage patterns have been studied by endoscopic retrograde cholangiopancreatography (ERCP) in four children with choledochal cyst (CC). The first two had mild or chemical pancreatitis; the third had a history of recurrent cholangitis and was diagnosed as chronic pancreatitis. The fourth manifested with severe, acute pancreatitis. All children were found to have an impaired flow through the papilla of Vater. In the first three cases, the duct of Santorini (DS) seemed to play an important role in the pancreatic drainage. In the fourth case, however, the duct was found to be absent. ERCP findings in additional eleven children without CC also were reviewed, and in this group the DS did not seem to play any significant role in pancreatic drainage. These results indicate that in children with common bile duct (CBD) anomalies, the DS may relieve the obstruction and ameliorate the pancreatitis.- - - - - - - - - - ranking = 0.16666666666667keywords = papilla (Clic here for more details about this article) |
5/8. Endoscopic sphincterotomy and removal of pancreatic duct stones.Chronic pancreatitis may be associated with pancreatic duct dilatation and ductal stones. Such stones are undoubtedly the result of chronic pancreatitis and stasis within the ductal system and may themselves serve to exacerbate ductal obstruction and recurrent episodes of pancreatitis. Endoscopic sphincterotomy has been used to relieve common duct obstruction secondary to biliary stones. This report suggests that sphincterotomy may also be used to approach selected patients who have pancreatic duct stones and recurrent pancreatitis. The technique involves a preliminary ERCP followed by standard endoscopic sphincterotomy with the papillatome positioned in the bile duct. A balloon catheter is then directed into the pancreatic duct orifice to extract ductal calculi. Although the main duct may be cleared, side branches are more difficult, and perhaps unnecessary, to clear. This method has provided relief of pain in a limited series of patients and may mark the beginning of a more aggressive approach to pancreatic endoscopy.- - - - - - - - - - ranking = 0.16666666666667keywords = papilla (Clic here for more details about this article) |
6/8. pancreas divisum: a teenager with calculi in the duct of Santorini. Report of a case treated by double drainage procedure.Since the age of sixteen, a teenager suffers from acute recurrent pancreatitis with a weight loss of 17 kg, without evident etiologic factor. At laparotomy the duct of Wirsung is absent; calculi are found in a grossly dilated duct of Santorini and the minor papilla is stenosed with periductal fibrosis and a large retention pseudocyst. Recurrent pancreatitis is cured by sphincteroplasty of the minor papilla and side-to-side pancreatico-jejunostomy. After a follow-up of 17 months the recurrent pancreatitis seems cured by sphincteroplasty of the minor papilla and side-to-side pancreatico-jejunostomy.- - - - - - - - - - ranking = 0.5keywords = papilla (Clic here for more details about this article) |
7/8. Parotid saliva tests in patients with pancreatic diseases before and after surgery.Two patients with pancreatic cyst were treated by cystojejunostomy, two others with pancreaticolithiasis by pancreaticojejunostomy (side to side), and pancreato-duodenectomy was done in one patient with cancer of the duodenal papilla and in one patient with cancer of the intrapancreatic bile duct. All these patients made uneventful recovery. In all these cases, parotid gland function was found depressed. After the operation, four patients showed normal parotid gland function and in one patient it was abnormally elevated. Thus, as previously reported in animal experiments, the parotid gland function was presumed to return to normal or to be elevated in parallel with the improvement of the pancreatic function or lesions.- - - - - - - - - - ranking = 0.16666666666667keywords = papilla (Clic here for more details about this article) |
8/8. Pancreatic mucin-producing adenocarcinoma associated with a pancreatic stone: report of a case.We present an autopsy case of an 83-year-old Japanese man with a mucin-producing adenocarcinoma accompanied by pancreatolithiasis in the head of the pancreas. He suffered from obstructive jaundice and died of disseminated intravascular coagulation. He did not normally drink alcohol and had no history of chronic pancreatitis. The autopsy findings revealed a mucinous cystic tumor, composed of multiple dilatated branches, in the head of the pancreas. Histological examinations showed papillary adenocarcinoma, which scirrhously infiltrated the distal common bile duct with perineural invasion and lymph node involvement. He was thus diagnosed to have mucin-producing branch-type cancer in the head of the pancreas. The main pancreatic duct was dilated, and the residual pancreatic tissue showed moderate fibrosis and parenchymal atrophy. A stone was observed in a dilated branch of the primary lesion. To the best of our knowledge, there have only been five previously reported cases of mucin-producing tumor associated with pancreatolithiasis. Intraductal calcification is a major characteristic of chronic pancreatitis, but it is clinically important not to misdiagnose cancers associated with pancreatolithiasis such as chronic pancreatitis.- - - - - - - - - - ranking = 0.16666666666667keywords = papilla (Clic here for more details about this article) |