Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations

BMC Gastroenterology

Kuni Ohtomo⁴  Kazuhiko Koike¹  Naoki Okura²  Kansei Uno⁵  Minoru Tada¹  Shigeru Kiryu³  Takeharu Yoshikawa⁵  Eriko Maeda⁵  Naoto Hayashi⁵  Masaaki Akahane⁴  Kazuchika Hagiwara⁴  Hiroyuki Akai⁴  Wataru Gonoi⁴ 

[1] Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan;Department of Radiology, Japan Labour Health and Welfare Organization, Kanto Rosai Hospital, Kawasaki City, Kanagawa, Japan;Department of Radiology, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan;Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan;Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan

关键词: Wirsungocele;    Pancreatic duct;    Magnetic resonance imaging;    Dorsal pancreatic duct;    Cross-sectional study;    Congenital anomaly;   

Others  :  858091
DOI  :  10.1186/1471-230X-13-62

 received in 2012-11-25, accepted in 2013-04-08,  发布年份 2013

【 摘 要 】

Background

Only one case of santorinicele without pancreas divisum pathophysiology (SWOPP) was previously reported. The purpose of the study was to determine the gross prevalence of SWOPP and santorinicele with pancreas divisum (SWPD) in community and patient populations, and investigate their clinical and radiographic features.

Methods

This cross-sectional study was performed at a tertiary referral centre. The Patient group comprised 2035 consecutive patients enrolled in the study who underwent magnetic resonance cholangiopancreatography (MRCP) studies. The Community group comprised 2905 consecutive subjects who participated in our whole-body medical check-up program that routinely includes MRCP studies. SWOPP was diagnosed when a saccular dilatation of the terminal portion of the dorsal pancreatic duct was observed unaccompanied by pancreas divisum or dominant dorsal duct. The prevalence of SWOPP and SWPD, and the clinical and radiological features were assessed in each group.

Results

Five cases of SWOPP were found in the Patient group (age range, 67–85 years; mean age, 73.6 years) (5/2035 = 0.25%; 95% confidence interval, 0.07–0.57); there were no cases of SWOPP in the Community group (0/2905 = 0.00%; 95% confidence interval, 0.00–0.10) (P = 0.01). Previous history of pancreatitis (4/5) and chronic pancreatitis (3/5) was more common in patients with SWOPP than in other subjects in the Patient or Community groups (both P < 0.05). Two cases of SWOPP were accompanied by reverse-Z type meandering main pancreatic duct. Six cases of SWPD were found. These cases were asymptomatic in 4/6, had a larger santorinicele (6.9 mm) than SWOPP patients (4.5 mm; P = 0.02), and were not associated with pancreatitis (0/6).

Conclusions

The second to sixth reported cases of SWOPP were presented. SWOPP is a relatively rare condition found mostly in patients suffering pancreatitis, especially chronic pancreatitis, and may be an acquired condition. Santorinicele is not always accompanied by pancreas divisum.

【 授权许可】

   
2013 Gonoi et al.; licensee BioMed Central Ltd.

【 图 表 】

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