膵管癒合不全
WordNet
- a large elongated exocrine gland located behind the stomach; secretes pancreatic juice and insulin
PrepTutorEJDIC
- 膵臓(すいぞう)
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/11 19:31:48」(JST)
[Wiki en表示]
| Pancreas divisum |
| Classification and external resources |
| Specialty |
medical genetics |
| ICD-10 |
Q45.3 |
| ICD-9-CM |
751.7 |
| DiseasesDB |
31894 |
| MedlinePlus |
000247 |
| eMedicine |
radio/520 |
Pancreas or Pancreatic divisum is a congenital anomaly in the anatomy of the ducts of the pancreas in which a single pancreatic duct is not formed, but rather remains as two distinct dorsal and ventral ducts.
Contents
- 1 Causes
- 2 Symptoms
- 3 Diagnosis
- 4 Treatment
- 5 References
- 6 External links
Causes
The human embryo begins life with two ducts in the pancreas, the ventral duct and the dorsal duct. Normally, the two ducts will fuse together to form one main pancreatic duct; this occurs in more than 90% of embryos. In approximately 10% of embryos the ventral and dorsal ducts fail to fuse together, resulting in pancreas divisum. In utero, the majority of the pancreas is drained by the dorsal duct which opens up into the minor papilla. The ventral duct drains the minority of the pancreas and opens into the major papilla. In adults however, this situation is reversed whereby 70% of the pancreas is drained by the ventral duct. Therefore in pancreas divisum, where fusion of the ducts does not occur, the major drainage of the pancreas is done by the dorsal duct which opens up into the minor papilla.
Symptoms
A majority of individuals born with pancreas divisum will not have symptoms. In some cases, pancreas divisum is only detected during autopsy.[1] A small group of individuals will develop symptoms which commonly include abdominal pain, nausea, vomiting, and acute and chronic pancreatitis.[2]
Diagnosis
MRCP image of pancreas divisum.
The most common and accurate way of diagnosing an individual with this anomaly is by MRCP (Magnetic Resonance Cholangiopancreatography) or ERCP (Endoscopic Retrograde Cholangiopancreatography). This test can demonstrate the presence of two separately draining ducts within the pancreas. Other tests can assist doctors with diagnosis, such as a CT scan and an MRI.
Treatment
Pancreas divisum in individuals with no symptoms does not require treatment. Treatment of those with symptoms varies and has not been well established. A surgeon may attempt a sphincterotomy by cutting the minor papilla to enlarge the opening and allow pancreatic enzymes to flow normally. During surgery, a stent may be inserted into the duct to ensure that the duct will not close causing a blockage. This surgery can cause pancreatitis in patients, or in rare cases, kidney failure and death.
An association with adenoma of the minor papilla has been reported.[3]
References
- ^ Pancreatic Divisum at eMedicine
- ^ http://www.georgetownuniversityhospital.org/body_dept.cfm?id=558058[full citation needed]
- ^ Nakamura Y, Tajiri T, Uchida E, et al. (2007). "Adenoma of the minor papilla associated with pancreas divisum". Hepatogastroenterology 54 (78): 1841–3. PMID 18019730.
External links
- MedicineNet
- 00303 at CHORUS
|
Congenital malformations and deformations of digestive system (Q35–Q45, 749–751)
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| Upper GI tract |
| Tongue, mouth and pharynx |
- Cleft lip and palate
- Van der Woude syndrome
- tongue
- Ankyloglossia
- Macroglossia
- Hypoglossia
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| Esophagus |
- EA/TEF
- Esophageal atresia: types A, B, C, and D
- Tracheoesophageal fistula: types B, C, D and E
- esophageal rings
- Esophageal web (upper)
- Schatzki ring (lower)
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| Stomach |
- Pyloric stenosis
- Hiatus hernia
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| Lower GI tract |
| Intestines |
- Intestinal atresia
- Meckel's diverticulum
- Hirschsprung's disease
- Intestinal malrotation
- Dolichocolon
- Enteric duplication cyst
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| Rectum/anal canal |
- Imperforate anus
- Rectovestibular fistula
- Persistent cloaca
- Rectal atresia
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| Accessory |
| Pancreas |
- Annular pancreas
- Accessory pancreas
- Johanson–Blizzard syndrome
- Pancreas divisum
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| Bile duct |
- Choledochal cysts
- Biliary atresia
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| Liver |
- Alagille syndrome
- Polycystic liver disease
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Index of the mouth
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| Description |
|
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| Disease |
- Congenital
- face and neck
- cleft
- digestive system
- Neoplasms and cancer
- Other
- Symptoms and signs
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| Treatment |
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Index of digestion
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|
| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Congenital
- Neoplasms and cancer
- Inflammatory bowel disease
- Gluten sensitivity
- Other
- Symptoms and signs
- Blood tests
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| Treatment |
- Procedures
- Drugs
- anabolic steroids
- antacids
- diarrhoea and infection
- bile and liver
- functional gastrointestinal disorders
- laxatives
- peptic ulcer and reflux
- nausea and vomiting
- other
- Surgery
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UpToDate Contents
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English Journal
- Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy.
- Boninsegna E1, Manfredi R, Ventriglia A, Negrelli R, Pedrinolla B, Mehrabi S, Gabbrielli A, Pozzi Mucelli R.
- European radiology.Eur Radiol.2015 Aug;25(8):2437-44. doi: 10.1007/s00330-015-3644-0. Epub 2015 Feb 19.
- OBJECTIVES: To evaluate secretin-enhanced MRCP (S-MRCP) findings of patients with pancreas divisum and Santorinicele, before and after minor papilla sphincterotomy.METHODS: S-MRCP examinations of 519 patients with suspected pancreatic disease were included. Size of the main pancreatic duct, presence
- PMID 25693665
- Intraductal papillary mucinous carcinoma of the pancreas associated with pancreas divisum: a case report and review of the literature.
- Nishi T1,2, Kawabata Y3, Ishikawa N4, Araki A5, Yano S6, Maruyama R7, Tajima Y8.
- BMC gastroenterology.BMC Gastroenterol.2015 Jul 8;15:78. doi: 10.1186/s12876-015-0313-3.
- BACKGROUND: Pancreas divisum, the most common congenital anomaly of the pancreas, is caused by failure of the fusion of the ventral and dorsal pancreatic duct systems during embryological development. Although various pancreatic tumors can occur in patients with pancreas divisum, intraductal papilla
- PMID 26152300
Japanese Journal
- 膵管非癒合と胆管非拡張型膵・胆管合流異常を合併した1例
Related Links
- Pancreas divisum is the most common congenital anomaly of the pancreas. It occurs in approximately 7% of autopsy series (range, 1-14%). ... Mounzer Al Samman, MD Associate Clinical Professor, Department of ...
- Pancreas divisum is the most common congenital pancreatic anomaly, occurring in approximately 7 percent of subjects in autopsy series. More than 95 percent of patients with pancreatic divisum are asymptomatic, and it remains ...
Related Pictures
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- 英
- pancreas divisum
- 関
- 膵炎