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Gastric duplication associated with pancreas divisum diagnosed by a multidisciplinary approach before surgery

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World Journal of Gastroenterology 2010年第8期16卷 1031-1033页

作者： Marta Di Pisa Gabriele Curcio Gianluca Marrone Mariapina Milazzo Marco Spada Mario Traina Mario Traina Gastroenterology Service Department of Radiology IsMeTT-UPMC Department of Surgery IsMeTT-UPMC

We report a unique case of communicating gastric duplication associated with pancreas divisum,diagnosed with a multidisciplinary approach,including X-rays,computed tomography,magnetic resonance imaging,esophagogastro duodenoscopy,ultrasound endoscopy and histology. We believe that this approach constitutes a fuller diagnostic evaluation,resulting in better and safer surgery.

关键词： Gastric duplication pancreas divisum Computed tomography Magnetic resonance imaging Ultra-sonic endoscopy

Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

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World Journal of Gastroenterology 2007年第44期13卷 5954-5956页

作者： Manuel Gigena Hugo V Villar Negar G Knowles John T Cunningham Erik K Outwater Luis R Leon Jr University of Arizona Health Science Center and Southern Arizona Veteran Affairs Health Care System Surgery Section Tucson AZ 85723 United States

To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

关键词： Whipple procedure Puestow procedure pancreas divisum Intussusception Bowel obstruction

Utility of endoscopic ultrasound in pancreatitis:A review

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World Journal of Gastroenterology 2007年第47期13卷 6321-6326页

作者： Maged K Rizk Henning Gerke University of Iowa Hospitals and Clinics Division of Gastroenterology and Hepatology Department of Internal Medicine 200 Hawkins Drive Iowa City IA 52242 United States

The close proximity of the endoscopic ultrasound probe to the pancreas results in superior spatial resolution compared to CT scan and MRI. In addition, endoscopic ultrasound (EUS) is a minimally invasive procedure that does not share the relatively high complication rate of ERCP. Due to these advantages, EUS has evolved into an important technique to assess pancreatobiliary disease. This review will discuss the role of EUS in patients with pancreatitis. The indications can be divided into acute pancreatitis and chronic pancreatitis. In acute pancreatitis, EUS is used to determine the etiology; in suspected chronic pancreatitis it is helpful to establish the diagnosis. Lastly, this review will discuss biliary pancreatitis with suspicion for persistent choledocholithiasis.

关键词： Idiopathic pancreatitis Acute pancreatitis Chronic pancreatitis Endsocopic ultrasound Endosonography pancreas divisum Cholelithiasis Microlithiasis Choledocholithiasis Biliary pancreatitis

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

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World Journal of Gastroenterology 2007年第45期13卷 5971-5978页

作者： Pier Alberto Testoni MD Division of Gastroenterology Vita-Salute San Raffaele University Scientif ic Institute San Raffaele Milan 20132 Italy

The role of endoscopic therapy in the management of pancreatic diseases is continuously evolving; at present most pathological conditions of the pancreas are successfully treated by endoscopic retrograde cholangio- pancreatography （ERCP） or endoscopic ultrasound （EUS）, or both. Endoscopic placement of stents has played and still plays a major role in the treatment of chronic pancreatitis, pseudocysts, pancreas divisum, main pancreatic duct injuries, pancreatic fistulae, complications of acute pancreatitis, recurrent idiopathic pancreatitis, and in the prevention of post-ERCP pancreatitis. These stents are currently routinely placed to reduce intraductal hypertension, bypass obstructing stones, restore lumen patency in cases with dominant, symptomatic strictures, seal main pancreatic duct disruption, drain pseudocysts or fluid collections, treat symptomatic major or minor papilla sphincter stenosis, and prevent procedure-induced acute pancreatitis. The present review aims at updating and discussing techniques, indications, and results of endoscopic pancreatic duct stent placement in acute and chronic inflammatory diseases of the pancreas.

关键词： Chronic pancreatitis pancreas divisum Pancreatic pseudocyst Pancreatic fistulas Idiopathicrecurrent pancreatitis Main pancreatic duct stenting Pancreatic dorsal duct stenting

Endoscopic therapy in acute recurrent pancreatitis

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World Journal of Gastroenterology 2008年第7期14卷 1034-1037页

作者： John Baillie Hepatobiliary and Pancreatic Disorders Service Wake Forest University Health SciencesWinston-SalemNorth Carolina 27157United States

Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a largely diagnostic to a largely therapeutic modality. Cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), and less invasive endoscopy, especially endoscopic ultrasound (EUS), have largely taken over from ERCP for diagnosis. However, ERCP remains the "first line" therapeutic tool in the management of mechanical causes of acute recurrent pancreatitis, including bile duct stones (choledocholithiasis), ampullary masses (benign and malignant), congenital variants of biliary and pancreatic anatomy (e.g. pancreas divisum, choledochoceles), sphincter of Oddi dysfunction (SOD), pancreatic stones and strictures, and parasitic disorders involving the biliary tree and/or pancreatic duct (e.g Ascariasis, Clonorchiasis).

关键词： Acute pancreatitis Endoscopic retrograde cholangiopancreatography Endoscopic Ultrasound Choledocholithiasis Ampullary lesions Cystic tumors of the pancreas Sphincter of Oddi dysfunction pancreas divisum Choledochal cyst Pancreatic stones