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ERCP and CT diagnosis of pancreas divisum and its relation to etiology of chronic pancreatitis

World Journal of Gastroenterology 1998年第2期4卷 58-60页

AIM To inquire into the ERCP and CT features of pancreas divisum (PD) and its role in the etiology of chronic pancreatitis. METHODS Fourteen patients with PD were analyzed in regard to the findings in ERCP and CT, the activities of serum amylase and the incidence of pancreatitis. Dorsal ductography via minor papilla cannulation was performed in six of them. RESULTS The length of dorsal and ventral pancreatic duct was 16 56cm±2 52cm and 5 55cm±1 46cm. Most of the patients had dilatation of dorsal (10/14) and ventral (8/14) duct and the stenosis of dorsal duct terminal (10/14). Delayed clearance of contrast in dorsal duct was found in 8 patients. The size and contour of the pancreas were normal in all the patients at conventional CT. pancreatitis was identified in 13 patients. CONCLUSION Dorsal ductography was necessary in the diagnosis of PD. Conventional CT play little role in the diagnosis of PD. Patients with PD run a higher risk of pancreatitis due to the stenosis of the minor papilla.

关键词： pancreatitis/etiology pancreas divisum/radiography cholangiopancreatography, endoscopic retrograde pancreatitis/diagnosis chronic diseases amylases/blood pancreatic ducts/radiography

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Current concept of pathogenesis of severe acute pancreatitis

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World Journal of Gastroenterology 2000年第1期6卷 32-36页

作者： Wu XN Department of Gastroenterology Shanghai First People's HospitalShanghai 200080China

The pathogenesis of severe acute pancreatitis isvery *** is a multifactorial as well asmultifaceted *** of all,the etiologicagents initiate the pancreatic acinar injury by releaseof pancreatic enzymes and overstimulat... 详细信息

关键词： Subject headings pancreatitis/etiology pancreatitis/diagnosis pancreatitis/pathophysiology

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An experimental study in etiologic effect of pancreas divisum on chronic pancreatitis and its pathogenesis

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World Journal of Gastroenterology 1998年第6期4卷 78-80页

作者： HE Hui, LU Wei Fu, KE Ya Zhu and ZHANG Yi Min

AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided into 4 groups ( n =8). Group Ⅰ: The communicating branch between the dorsal and ventral pancreatic ducts was partly ligated. Group Ⅱa: The communicating branch was amputated and completely ligated. Group Ⅱb: The dorsal duct was amputated and ligated at 2mm distance to the minor papilla. Group Ⅲ: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipase A2 (PLA2) and amylase (Ams) were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductography and the pathologic examination were made. RESULTS The activities of serum PLA2 and Ams in Group Ⅰ,Ⅱa and Ⅱb were significantly increased 5-80 days after operation. At sacrifice, the basal pressures of the ventral duct were significantly higher 30min-60min after provocation in Group Ⅰ, Ⅱa and Ⅱb. The pressures of the dorsal duct were significantly increased in Group Ⅱb but no difference in Group Ⅰ and Ⅱa. Under light microscopy the fibrosis of interlobus and periducts, the destruction of acini and infiltration of inflammatory cell in dorsal and ventral pancreas were found in Group Ⅱb. But in Group Ⅰ and Ⅱa, these findings were present only in ventral pancreas. The electron microscopy showed that in ventral pancreas of Groups Ⅰ and Ⅱa and the dorsal and ventral pancreas of Group Ⅱb, the rough endoplasmic reticulum of the acinar cells showed granules scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen. CONCLUSION PD is one of etiologic factors in chronic pancreatitis. The pathogenesis is the functional obstruction of the minor papilla at the peak stage of secretion.

关键词： pancreatitis/etiology pancreatitis/physiopathology paucreas divism/physiopathology paucreas divism/etiology chronic diseases

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