RESUMEN
BACKGROUND: To determine the effect of intramuscular administration of Neostigmine® on the visualization of the pancreatic duct on magnetic resonance cholangiopancreatography in patients with recurrent acute pancreatitis or abdominal pain. METHODS: We reviewed patients undergoing magnetic resonance cholangiopancreatography followed by a Neostigmine®-enhanced magnetic resonance cholangiopancreatography. Patients with a history of recurrent acute pancreatitis or abdominal pain who had a magnetic resonance cholangiopancreatography where the pancreatic duct was not entirely seen, were selected to undergo a second magnetic resonance cholangiopancreatography 40 minutes after 0.5 mg Neostigmine®. Images were analyzed by 2 radiologists. The diameter of the pancreatic duct was measured in the head, body, and tail of the pancreas on the baseline images and after Neostigmine®. RESULTS: Ten patients were included, with a median age of 33 years (range 15-61). The maximum diameter of the pancreatic duct increased significantly after Neostigmine® administration in all patients, from 1.84 ± 0.98 to 3.41 ± 1.27 mm in the head, 1.34 ± 0.42 mm to 2.5 ± 0.49 mm in the body and 0.72 ± 0.52 mm to 1.78 ± 0.43 mm in the tail (mean ± SD, P < .0001). Neostigmine® helped to provide better detail of the pancreatic duct anatomy in 4 patients. In 2 patients we confirmed pancreas divisum, in another the Santorini duct was not seen on the baseline images but it was clearly visualized after Neostigmine®, and in the fourth patient, Neostigmine® improved visualization of multiple pancreatic duct stenosis. CONCLUSION: Neostigmine®-magnetic resonance cholangiopancreatography significantly increases the diameter of the pancreatic duct, allowing an accurate morphological evaluation. It could be a cheap alternative to secretin, which is expensive and hardly available.
Asunto(s)
Pancreatitis , Secretina , Dolor Abdominal/diagnóstico por imagen , Dolor Abdominal/tratamiento farmacológico , Dolor Abdominal/etiología , Enfermedad Aguda , Adolescente , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Pancreatocolangiografía por Resonancia Magnética , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neostigmina , Páncreas/patología , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patología , Pancreatitis/patología , Adulto JovenRESUMEN
Se comunica el primer reporte nacional del tratamiento de pancreatitis aguda recidivante mediante derivación Wirsung-yeyunal en pediatría. Se trata de un paciente con múltiples ingresos hospitalarios por episodios de pancreatitis, con complicaciones evolutivas de pseudoquistes pancreáticos, estenosis y litiasis del conducto de Wirsung. Se realiza derivación Wirsung-yeyunal por vía convencional con buena evolución posterior.
The first national report of the treatment of recurrent acute pancreatitis by means of Wirsung-jejunal diversion in pediatrics is communicated. This is a patient with multiple hospital admissions for episodes of pancreatitis, with evolutionary complications of pancreatic pseudocysts, stenosis, and Wirsung duct lithiasis. Wirsung-jejunal bypass was performed by conventional route with good subsequent evolution.
O primeiro relato nacional do tratamento de pancreatite aguda recorrente por derivação Wirsung-jejunal em pediatria é relatado. Trata-se de um paciente com múltiplas internações hospitalares por episódios de pancreatite, com complicações progressivas de pseudocistos pancreáticos, estenose e cálculos do ducto de Wirsung. A derivação Wirsung-jejunal foi realizada por via convencional com boa evolução posterior.
Asunto(s)
Humanos , Femenino , Niño , Conductos Pancreáticos/cirugía , Pancreatitis/cirugía , Constricción Patológica/cirugía , Conductos Pancreáticos/diagnóstico por imagen , Pancreatitis/complicaciones , Recurrencia , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Enfermedad Aguda , Resultado del Tratamiento , Constricción Patológica/diagnóstico por imagen , Litiasis/diagnóstico por imagenRESUMEN
Este estudo teve como objetivo avaliar achados ultrassonográficos de cães e gatos diagnosticados com colestase, correlacionando alterações concomitantes com espécies, sexo, idade, peso, sinais clínicos e dilatação das vias biliares. O sistema biliar de pequenos animais é composto pela vesícula biliar e a árvore biliar. Desta forma, os felinos apresentam mais alterações nestas estruturas devido à anatomia diferenciada. A redução do fluxo biliar, conhecida como colestase, ocorre por inúmeras situações, sendo o ultrassom o principal exame diagnóstico empregado na medicina veterinária. Ductos biliares de 4 e 3mm de diâmetro são considerados normais para felinos e caninos, respectivamente. Neste estudo, os sistemas biliares de 41 animais, incluindo felinos e caninos, foram avaliados por ultrassonografia no Setor de Diagnóstico por Imagem do Hospital Veterinário de janeiro de 2019 a fevereiro de 2020, demonstrando a presença de cálculos vesicais em ambas as populações, assim como alterações em ducto cístico associados à pancreatite em cães.
This study aimed to evaluate ultrasound findings of dogs and cats diagnosed with cholestasis, correlating concomitant alterations with species, sex, age, weight, clinical signs, and dilation of bile ducts. The biliary system of small animals is composed of the gallbladder and the biliary tree. Thus, the felines show more alterations in these structures due to their differentiated anatomy. The reduction of the bile flow, known as cholestasis, occurs as a result of numerous situations, with ultrasound being the main diagnostic exam applied in veterinary medicine. Bile ducts of 4 and 3mm diameter are considered normal for felines and canines, respectively. In this study, the biliary systems of 41 animals, including felines and canines, were evaluated using ultrasound at the Diagnostic Imaging Sector of the Veterinary Hospital from January 2019 to February 2020, demonstrating the presence of bladder stones in both populations, as well as changes in the cystic duct associated with pancreatitis in dogs.
Asunto(s)
Animales , Gatos , Perros , Conductos Pancreáticos/diagnóstico por imagen , Sistema Biliar/diagnóstico por imagen , Colestasis/veterinaria , Vesícula Biliar/diagnóstico por imagen , Registros Médicos/estadística & datos numéricos , Ultrasonografía/veterinariaRESUMEN
OBJECTIVE: To compare the efficacy of magnetic resonance cholangiopancreatography (MRCP) with endoscopy retrograde cholangiopancreatography (ERCP) in children for the identification of pancreatic duct variants. STUDY DESIGN: We identified children with a pancreatic duct variant by ERCP and separately queried our MRCP database for similar variants. Patients with a paired ERCP-MRCP were reviewed. Three radiologists blinded to the ERCP and MRCP findings were asked to independently review the MRCP studies and define the pancreatic duct anatomy. These blinded reviewers also graded the magnetic resonance imaging examination quality. RESULTS: Seventy-four pairs of ERCP-MRCP examinations were identified. Pancreas divisum was the most frequent ductal variant encountered (73%). There was fair agreement between the radiology reviewers as to the quality of the magnetic resonance imaging studies (Fleiss Kappa agreement). Concordance of the reviewers with that of the ERCP was moderate for the exact diagnosis, moderate for the presence of pancreas divisum, and fair for agreement on the presence of any duct variant. Concordance among reviewers was moderate for the exact diagnosis, moderate for normal vs abnormal, and substantial for the presence of pancreas divisum. CONCLUSIONS: Diagnostic limitations exist when comparing MRCP with the gold reference standard of ERCP, specifically when assessing for pancreatic duct variants in children.
Asunto(s)
Colangiopancreatografia Retrógrada Endoscópica , Pancreatocolangiografía por Resonancia Magnética , Niño , Humanos , Imagen por Resonancia Magnética , Páncreas/diagnóstico por imagen , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patologíaRESUMEN
INTRODUCTION: Patients with unexplained dilated common bile duct (CBD) and/or dilated main pancreatic duct (MPD) on noninvasive abdominal imaging tests are often referred for endoscopic ultrasound (EUS) in order to rule out biliopancreatic cancer. The aim of the study was to evaluate the diagnostic yield of EUS in this patient group. METHODS: A prospective study was conducted. Patients with unexplained dilated CBD and/or MPD on abdominal imaging, who underwent EUS, were enrolled. RESULTS: Fifty-four patients underwent EUS (CBD dilation n=38, MPD dilation n=5 or both n=11). In 31/54 patients (57.4%), EUS revealed pathologic findings. Sixteen patients (29.6%) had EUS evidence of biliopancreatic cancer and 15 patients (27.7%) had benign pathology. Ten (62.5%) of the patients with biliopancreatic cancer had MPD dilation. MPD dilation was significantly associated with malignancy (P=0.017). CONCLUSION: Patients with unexplained dilated MPD on noninvasive image have a high risk of biliopancreatic malignancy detected by EUS.
Asunto(s)
Endosonografía , Neoplasias Pancreáticas , Humanos , Conductos Pancreáticos/diagnóstico por imagen , Neoplasias Pancreáticas/diagnóstico por imagen , Estudios Prospectivos , Estudios RetrospectivosAsunto(s)
Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Carcinoma Ductal Pancreático/cirugía , Humanos , Páncreas/diagnóstico por imagen , Páncreas/cirugía , Pancreatectomía , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/cirugía , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/cirugíaRESUMEN
Pancreatic fluids collections are local complications related to acute or chronic pancreatitis and may require intervention when symptomatic and/or complicated. Within the last decade, endoscopic management of these collections via endoscopic ultrasound-guided transmural drainage has become the gold standard treatment for encapsulated pancreatic collections with high clinical success and lower morbidity compared to traditional surgery and percutaneous drainage. Proper understanding of anatomic landmarks, including assessment of the main pancreatic duct and any associated lesions - such as disruptions and strictures - are key to achieving clinical success, reducing the need for reintervention or recurrence, especially in cases with suspected disconnected pancreatic duct syndrome. Additionally, proper review of imaging and anatomic landmarks, including collection location, are pivotal to determine type and size of pancreatic stenting as well as approach using long-term transmural indwelling plastic stents. Pancreatography to adequately assess the main pancreatic duct may be performed by two methods: Either non-invasively using magnetic resonance cholangiopancreatography or endoscopically via retrograde cholangiopan-creatography. Despite the critical need to understand anatomy via pancrea-tography and assess the main pancreatic duct, a standardized approach or uniform assessment strategy has not been described in the literature. Therefore, the aim of this review was to clarify the role of pancreatography in the endoscopic management of encapsulated pancreatic collections and to propose a new classification system to aid in proper assessment and endoscopic treatment.
Asunto(s)
Enfermedades Pancreáticas , Seudoquiste Pancreático , Colangiopancreatografia Retrógrada Endoscópica , Drenaje , Humanos , Enfermedades Pancreáticas/diagnóstico por imagen , Enfermedades Pancreáticas/cirugía , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/cirugía , Seudoquiste Pancreático/diagnóstico por imagen , Seudoquiste Pancreático/cirugía , Stents , Resultado del TratamientoRESUMEN
A ansa pancreática é uma variação anatômica rara dos ductos pancreáticos. Consiste numa comunicação entre o ducto pancreático principal (Wirsung) e o ducto pancreático acessório (Santorini). Recentemente, estudos têm demonstrado estar essa variação anatômica implicada como fator predisponente e significativamente associada a episódios recorrentes de pancreatite aguda. A pancreatite é uma entidade clínica pouco frequente na infância. Diferente dos adultos, as causas mais comuns incluem infecções virais, por ascaris, medicamentosas, traumas e anomalias estruturais. O objetivo deste estudo foi relatar um caso de pancreatite aguda grave não alcoólica e não biliar, em um paciente jovem de 15 anos, em cuja propedêutica imagenológica evidenciou-se alça, comunicando com os ductos pancreáticos ventral e dorsal, compatível com ansa pancreática.
Ansa pancreatica is a rare anatomical variation of the pancreatic ducts. It consists of communication between the main pancreatic duct (Wirsung) and the accessory pancreatic duct (Santorini). Recently, studies have shown that this anatomical variation is implicated as a predisposing factor and significantly associated with recurrent episodes of acute pancreatitis. Pancreatitis is a rare clinical entity in childhood. Different from that in the adults, the most common causes include viral and ascaris infections, drugs, traumas, and structural abnormalities. The objective of this study was to report a case of a severe non-alcoholic and non-biliary acute pancreatitis in a 15-year-old patient, whose propedeutic imaging showed a loop communicating with the ventral and dorsal pancreatic ducts, consistent with ansa pancreatica.
Asunto(s)
Humanos , Masculino , Adolescente , Conductos Pancreáticos/anomalías , Conductos Pancreáticos/diagnóstico por imagen , Pancreatitis/etiología , Pancreatitis/diagnóstico por imagen , Seudoquiste Pancreático/diagnóstico por imagen , Pancreatitis/complicaciones , Pancreatitis/sangre , Proteína C-Reactiva/análisis , Espectroscopía de Resonancia Magnética , Tomografía Computarizada por Rayos X , Ictiosis Vulgar/diagnóstico , Ultrasonografía , Conductos Biliares Extrahepáticos/patología , Pancreatitis Aguda Necrotizante/etiología , Pancreatitis Aguda Necrotizante/diagnóstico por imagen , Amilasas/sangre , Lipasa/sangreRESUMEN
OVERVIEW: Pancreaticobiliary maljunction (PBM) is a congenital malformation characterized by a long common pancreaticobiliary channel which causes sphincter of Oddi malfunction. In children, it is typically diagnosed using magnetic resonance cholangiopancreatography (MRCP). It is associated with congenital biliary dilatation, pancreatitis, and gallbladder and bile duct tumors at adulthood. Studies in the western population are rare. Given its morbidity rate, it should be searched for in the western pediatric population. The objective of this study was to look for and identify the presence of pancreaticobiliary maljunction through MRCP in pediatric patients with biliary or pancreatic disease, as well as to find out other associated factors. METHODS: MRCP was used to measure common channel length, pancreatic duct length, and bile duct diameter in 41 pediatric patients with biliary or pancreatic disease. RESULTS: The common channel could only be measured in 17.6% of cases, 50% of which were >8 mm long. All patients were female and had congenital biliary dilatation. No age-related differences were found in terms of bile duct length. CONCLUSIONS: PBM is present in the western pediatric population, but prevalence and morbidity are unknown. Larger studies are required to identify morbidity and mortality, as well as prevalence among patients.
OBJETIVO: La unión biliopancreática anómala (UBPA) es una malformación congénita caracterizada por un canal común pancreatobiliar largo que impide el adecuado funcionamiento del esfínter de Oddi. Su diagnóstico en niños se realiza comúnmente mediante colangiopancreatografía por resonancia magnética (CPRM). Se asocia a dilatación biliar congénita, pancreatitis y tumores de la vesícula y la vía biliar en la edad adulta. Los estudios en población occidental son escasos; debido a su morbilidad resulta de relevancia la búsqueda en población pediátrica occidental. Este estudio pretende buscar e identificar la presencia de unión biliopancreática anómala mediante CPRM de pacientes pediátricos con enfermedad de la vía biliar o pancreática, al igual que identificar otros factores asociados. METODOS: Se midió por CPRM la longitud del canal común, el conducto pancreático y el diámetro de la vía biliar de 41 pacientes pediátricos con patología biliar o pancreática. RESULTADOS: El canal común solo pudo ser medido en el 17,6% de los casos, de los cuales el 50% tuvo una longitud >8 mm, siendo todos ellos pacientes femeninos con dilatación biliar congénita; no se encontraron diferencias en la longitud de la vía biliar relacionado con la edad. CONCLUSIONES: La UBPA es una malformación que se encuentra presente en población pediátrica occidental con prevalencia y morbilidad desconocida; se requieren estudios a mayor escala para identificar morbimortalidad y prevalencia de pacientes con esta malformación.
Asunto(s)
Pancreatocolangiografía por Resonancia Magnética/métodos , Enfermedades Pancreáticas/diagnóstico por imagen , Conductos Pancreáticos/diagnóstico por imagen , Mala Unión Pancreaticobiliar/diagnóstico por imagen , Adolescente , Conductos Biliares/anomalías , Conductos Biliares/diagnóstico por imagen , Niño , Preescolar , Quiste del Colédoco/diagnóstico por imagen , Colombia , Femenino , Vesícula Biliar , Humanos , Lactante , Masculino , Conductos Pancreáticos/anomalías , Estudios RetrospectivosAsunto(s)
Conductos Pancreáticos , Pancreatoyeyunostomía , Constricción Patológica/etiología , Constricción Patológica/cirugía , Humanos , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/cirugía , Pancreatoyeyunostomía/efectos adversos , Stents , Ultrasonografía IntervencionalRESUMEN
Serous cystadenoma of the pancreas is a common cystic neoplasm typically of benign evolution that rarely communicates with the pancreatic ductal system. We present several images originating from two cases of serous cystadenoma of the pancreas which led to compression and dilatation of Wirsung's duct. These cases suggest that when the diagnosis of pancreatic microcystic lesion is detected, associated, or not associated with a central fibrous scar and a low carcinoembryonic antigen level in the aspirated fluid, the presence of dilatation of Wirsung's duct does not exclude the diagnosis of serous pancreatic cystadenoma.
Asunto(s)
Cistadenoma Seroso/complicaciones , Cistadenoma Seroso/diagnóstico por imagen , Conductos Pancreáticos/diagnóstico por imagen , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/diagnóstico por imagen , Anciano , Dilatación Patológica/diagnóstico por imagen , Femenino , Humanos , Conductos Pancreáticos/patologíaAsunto(s)
Humanos , Masculino , Adulto , Páncreas/fisiopatología , Conductos Pancreáticos/fisiopatología , Necrosis/diagnóstico por imagen , Páncreas/diagnóstico por imagen , Conductos Pancreáticos/diagnóstico por imagen , Colangiopancreatografia Retrógrada Endoscópica , Pancreatitis Aguda Necrotizante/complicaciones , Pancreatocolangiografía por Resonancia MagnéticaRESUMEN
The pancreatic biliary maljunction is a rare anomaly that affects mainly females, defined as an anatomical maljunction of the pancreatic duct and the biliary duct confluence, and may be a rare cause of recurrent acute pancreatitis. In order to early diagnosis and prompt treatment, ERCP has an important role in it
La Malformación de la unión biliopancreática es una afección rara y ocurre más en mujeres jóvenes. Es una causa de pancreatitis aguda de causa no conocida. CPRE es una herramienta eficiente para el diagnóstico y también para ser de la terapéutica
Asunto(s)
Adulto , Femenino , Humanos , Conductos Pancreáticos/anomalías , Pancreatitis/etiología , Conductos Biliares/anomalías , Colangiopancreatografia Retrógrada Endoscópica , Anomalías del Sistema Digestivo/diagnóstico por imagen , Conductos Pancreáticos/diagnóstico por imagen , Recurrencia , Conductos Biliares/diagnóstico por imagen , Anomalías del Sistema Digestivo/complicacionesAsunto(s)
Endoscopía del Sistema Digestivo/métodos , Endosonografía/métodos , Biopsia Guiada por Imagen/métodos , Conductos Pancreáticos , Neoplasias Pancreáticas , Somatostatinoma , Esfinterotomía Endoscópica/métodos , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/fisiopatología , Neoplasias Pancreáticas/cirugía , Somatostatinoma/patología , Somatostatinoma/fisiopatología , Somatostatinoma/cirugía , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
OBJECTIVES: Pancreatic stenting is used to improve painful, obstructive chronic pancreatitis. Data suggest that polyethylene stents (PESs) cause stent-associated changes (SACs). Whether a stent composed of more flexible material (Sof-Flex stent [SFS]) is associated with less SAC is unknown. METHODS: This study is a retrospective study of patients who underwent pancreatic duct stenting of at least 1 PES and 1 SFS on separate examinations and had a follow-up pancreatogram at the time of stent removal. The main outcome measurements were assessed for SAC on follow-up pancreatogram and interpreted by 2 radiologists blinded to the clinical data. RESULTS: Stent-associated changes were noted with 28% (13/47) of SFS and with 25% (13/52) of PES (P = 0.65). For 10F stent subgroups, SACs were seen with 25% (6/24) of the SFS compared with 50% (2/4) in the PES. Thirty percent (7/23) of the 8.5F SFS subgroup had SACs versus 29% (2/7) in the PES group (P = 0.887) for 8.5F + 10F combined comparison. CONCLUSIONS: In patients who have had polyethylene or SFSs of varying sizes, approximately 1 in 4 have SACs. Despite the use of a softer stent material for therapeutic stenting, the rate of SACs in the 8.5F and 10F subgroups seems similar between the 2 materials and design.
Asunto(s)
Conductos Pancreáticos/cirugía , Pancreatitis Crónica/cirugía , Polietileno , Stents/normas , Adulto , Anciano , Colangiopancreatografia Retrógrada Endoscópica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patología , Estudios Retrospectivos , Método Simple Ciego , Stents/efectos adversos , Stents/clasificación , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
The pancreatic biliary maljunction is a rare anomaly that affects mainly females, defined as an anatomical maljunction of the pancreatic duct and the biliary duct confluence, and may be a rare cause of recurrent acute pancreatitis. In order to early diagnosis and prompt treatment, ERCP has an important role in it.
Asunto(s)
Conductos Biliares/anomalías , Colangiopancreatografia Retrógrada Endoscópica , Anomalías del Sistema Digestivo/diagnóstico por imagen , Conductos Pancreáticos/anomalías , Pancreatitis/etiología , Adulto , Conductos Biliares/diagnóstico por imagen , Anomalías del Sistema Digestivo/complicaciones , Femenino , Humanos , Conductos Pancreáticos/diagnóstico por imagen , RecurrenciaRESUMEN
O diagnóstico da pancreatite é um desafio contínuo na medicina veterinária, visto que a mesma não apresenta sinais clínicos patognomônicos, sendo diagnosticada, em cães e gatos, como um achado acidental durante a necropsia. O exame ultrassonográfico é uma técnica de diagnóstico por imagem para visibilização de alterações do pâncreas, analisando de forma segura e não invasiva. O estudo teve como objetivo analisar e comparar as características e dimensões ultrassonográficas do pâncreas nos cães e gatos filhotes hígidos, estabelecendo padrões de normalidade e de referência. Foram utilizados no estudo 15 cães filhotes e 15 gatos filhotes com idade entre cinco e seis meses, sem raça definida e peso médio de 3 kg e 2 kg, respectivamente. Os animais foram submetidos ao exame ultrassonográfico do pâncreas, para visibilização das características internas do órgão e sua mensuração. O corpo e ambos os lobos pancreáticos foram observados em todos os grupos do estudo. Em ambos os grupos, o pâncreas foi visibilizado como uma estrutura linear e com ecotextura homogênea, hipoecogênica e com margens definidas. O lobo pancreático direito foi visibilizado ligeiramente hiperecogênico em relação ao lobo caudato hepático, enquanto o lobo pancreático esquerdo e o corpo pancreático foram visibilizados hipoecogênicos em relação ao parênquima esplênico, isoecoicos em relação ao fígado e hipoecogênicos em relação à gordura mesenterica. O corpo pancreático dos cães e dos gatos filhotes mediram 4,2 mm ± 0,10 mm e 4,1 mm ± 0,09 mm, respectivamente. Os lobos pancreáticos direito e esquerdo dos cães filhotes mediram 5,4 mm ± 0,20 mm (sagital), 5,4 mm ± 0,10 mm (transversal), e 4,4 mm ± 0,20 mm, respectivamente. Nos gatos filhotes mediram 2,7 mm ± 0,01 mm (sagital e transversal), e 3,6 mm + 0,02 mm, respectivamente. Os valores das mensurações do corpo e lobos pancreáticos dos cães filhotes foram maiores em relação aos gatos filhotes. O estudo forneceu valores de referência de dimensões do corpo e lobos pancreáticos para cães e gatos filhotes hígidos com idade entre 5 e 6 meses.
The diagnosis of pancreatitis is a challenge in veterinary medicine because there are no pathognomonic clinical signs, and the diagnostic in dogs and cats is an incidental finding during necropsy. The ultrasonography is an imaging technique which visualize the pancreas changes safely and noninvasively. The aim of the study was to analyze and compare the ultrasonographic characteristics and dimensions of the pancreas in health puppies and kittens, establishing standards of normality and references. Fifteen healthy puppies with mean weight of 3 kg and fifteen healthy kittens with mean weight of 2 kg, with age between five and six months, cross breed, were included in the study. All animals were submitted to ultrasound exam of pancreas for visualization of their internal characteristics. In both groups, the pancreas was visualized. In puppies and kittens were observed the body and the both pancreatic lobes. The pancreas was visualized as a linear structure with homogeneous hypoechoic echotexture and defined margins. The right pancreatic lobe was visualized slight hyperechoic relative to the liver caudate lobe, while the left pancreatic lobe and pancreatic body were observed hypoechoic in relation to the spleen, isoechoic in relation to the liver parenchyma and hypoechoic in relation to the mesenteric fat. The puppies and kittens pancreatic body measured 4.2 mm ± 0.10 mm and 4.1 mm ± 0.09 mm, respectively. The puppy's pancreatic lobes right and left measured 5.4 mm ± 0.20 mm (sagittal), 5.4 mm ± 0.10 mm (transversal), and 4.4 mm, respectively. In kittens was measured 2.7 mm ± 0.01 mm (sagittal and transversal), and 3.6 mm ± 0.02 mm, respectively. The puppies' body and pancreatic lobes was observed bigger than the kittens. The study provided reference values of body and pancreatic lobes for healthy puppies and kittens with age between 5 and 6 months.
El diagnóstico de la pancreatitis es un desafío permanente en la medicina veterinaria, ya que no tiene signos clínicos patognomónicos y lo se diagnostica en perros y gatos como un hallazgo incidental durante la necropsia. La ecografía es la técnica de imagen para la visualización de los cambios en el páncreas y capaz de analizar de forma segura y no invasiva. El objetivo del estudio fue analizar y comparar las características y dimensiones del páncreas ecográficos en cachorros y cachorros de gato sanos, estableciendo los rangos normales y de referencia. Fueran utilizados en el estudio 15 cachorros e 15 cachorros de gato de entre cinco y seis meses y peso entre 3 kg y 2 kg, respectivamente. Los animales fueron sometidos a examen ultrassonográfico del páncreas para la visualización de las características internas del órgano y su medición. En cachorros y cachorros de gato se observó el cuerpo y ambos lóbulos del páncreas. En ambos grupos, el páncreas se visualizó como una estructura lineal, homogénea y hipoecoica y márgenes definidos. El lóbulo derecho de páncreas se visualizó ligeramente hiperecoico en relación con el lóbulo caudado del hígado, mientras que el lóbulo pancreático izquierdo y el cuerpo de páncreas se observaron hipoecoica en relación al bajo, isoecoicos en relación al parénquima del hígado y hipoecoica con relación a la grasa mesenterica. O cuerpo del páncreas de cachorros y cachorros de gato mide 4,2 mm ± 0,10 mm y 4,1 mm ± 0,09 mm, respectivamente. Los lóbulos derecho e izquierdo del páncreas de cachorro miden 5,4 mm ± 0,20 mm (sagital), 5,4 mm ± 0,10 mm (horizontal) y 4,4 mm ±0, 20 mm, respectivamente. En los cachorros de gato medido 2,7 mm ± 0,01 mm (sagital y transversal) y 3,6 mm ± 0,02 mm, respectivamente. Los cuerpos e lobos del páncreas de los cachorros fueran mayores en relación los gatos. O estudio revelo los valores de referencia del para el tamaño del cuerpo y lobos pancreáticos para cachorros y cachorros de gato sanos con edad entre de 5 a 6 meses.
Asunto(s)
Animales , Gatos , Perros , Páncreas/anatomía & histología , Conductos Pancreáticos/diagnóstico por imagen , Pancreatitis/veterinaria , Pancreatitis/diagnóstico por imagen , Animales Lactantes , Ultrasonografía/veterinaria , Abdomen/anatomía & histologíaRESUMEN
Case report of pancreas divisum dorsal pancreatic duct access with endoscopic ultrasonography help to relief pain in a patient with not possible access by PCRE.
Asunto(s)
Drenaje/métodos , Endosonografía , Conductos Pancreáticos/anomalías , Pancreatitis/etiología , Ultrasonografía Intervencional , Enfermedad Aguda , Adulto , Drenaje/instrumentación , Humanos , Masculino , Conductos Pancreáticos/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , Pancreatitis/terapia , Recurrencia , StentsRESUMEN
Intraductal papillary mucinous neoplasm of the pancreas is characterized by a dilatation of the main pancreatic duct and/or secondary ducts, mucin production and the absence of ovarian-like struma. The symptoms are non-specific and often the diagnosis is incidental. The treatment of choice is surgery, since these tumors may become malignant. The prognosis depends on the type of lesion, whether the excision is complete and lymph node involvement. The aim of this review is to analyze the clinical, diagnostic, therapeutic and pathological characteristics of this disease.