Spatial assessment by magnetic resonance cholangiopancreatography for preoperative imaging in partial pancreatic head resection

2001 ◽  
Vol 182 (2) ◽  
pp. 188-191 ◽  
Author(s):  
Kunihiko Izuishi ◽  
Toshio Nakagohri ◽  
Masaru Konishi ◽  
Kazuto Inoue ◽  
Hisao Tajiri ◽  
...  
2021 ◽  
pp. 61-64
Author(s):  
Santosh Kumar Prasad ◽  
Nupur Nupur ◽  
Akshit Pathak ◽  
Indra Shekhar Thakur ◽  
Vijay Shankar Prasad

INTRODUCTION: Jaundice means yellow due to the yellowish discolouration of skin, sclera, and mucous membrane seen in jaundice caused by bilirubin pigment. It is divided in to two forms obstructive(surgical) and non- obstructive (non-surgical). AIM AND OBJECTIVE: To evaluate patients of obstructive jaundice by sonography and magnetic resonance cholangiopancreatography and compare the reporting and ndings by both the modalities. MATERIALS AND METHODS: Cross sectional observational study done from November 2018 to October 2020 and consists of 32 patients who had clinical jaundice and consented to being subjected to both ultrasound and MRCP. OBSERVATIONS:Both USG and MRCP were able to detect extrahepatic CBD dilatation equally in 25 patients. In 5(15.6%) patients USG and MRI both demonstrated intrahepatic mass causing obstruction at the level of conuence of right and left hepatic duct or CHD. Ultrasonography was able to detect the intrinsic mass of the extrahepatic common bile duct in 2(6.2%) patients out of 32 patients in our study population. MRCP could detect the same in 6(18.7%) patients. In our study narrowing of CBD with stricture formation and upstream dilatation of biliary tree was identied in 10(31.2%) patients on MRCP. Ultrasound could diagnose the same in one patient. Both USG and MRCP were able to detect pancreatic head mass as well as pseudocyst. CONCLUSION: The accuracy of MRCP was found to be comparable to that of ERCP for diagnosis of etiology for obstructive jaundice. MRCP allows better lesion characterization and assessment. However, the patchy availability of MR machines become the main achilles heel for the surgeons as well as the radiologists. Hence the valuable role of the omnipresent ultrasonography become immense.


2013 ◽  
Vol 79 (5) ◽  
pp. 470-475
Author(s):  
Tao-Tao Zhang ◽  
Ke-Jian Guo ◽  
Gang Ma ◽  
Shao-Wei Song

Retropancreatic retroperitoneal tumors (RRTs) are seldom encountered in clinical practice. The lack of characteristics on clinical presentation and imaging make preoperative diagnosis difficult and surgical management remains a challenge. This retrospective report surveys the presenting diagnosis and surgical management of 38 patients with RRTs presenting at our center between August 1981 and May 2012. Six patients were misdiagnosed on the basis of computerized tomography and one each by magnetic resonance imaging and magnetic resonance cholangiopancreatography. Tumors were localized posterior to the pancreatic head and uncinate process (n = 18); posterior to the neck and body of the pancreas (n = 9); or posterior to the body and tail of the pancreas (n = 11). Thirty-three patients underwent surgical resections. Operative approaches were chosen on the basis of tumor size and localization. The tumors were mostly commonly originating from neurogenic tissue (n = 16). There were 25 benign neoplasms (65.8%), 10 malignant tumors (26.3%), and three undefined tumors. The morbidity of postsurgical complications was 21 per cent (eight of 38). The number of patients who underwent follow-up was 21, and the mean follow-up time was 35 months (range, 2 to 90 months). Three patients died during follow-up. The morbility of local recurrence was 10.5 per cent (four of 38). Definitive diagnosis of RRTs is made at laparotomy. Complete resection remains the fundamental objective of disease management. Different operative approaches should be used according to tumor localization and size.


1999 ◽  
Vol 15 (8) ◽  
pp. 546-548 ◽  
Author(s):  
E. W. A. van Heurn-Nijsten ◽  
G. Snoep ◽  
G. Kootstra ◽  
J. W. M. Greve ◽  
P. Forget ◽  
...  

2019 ◽  
Vol 48 (5) ◽  
pp. 030006051988414
Author(s):  
Jin Wei Zhong ◽  
Ling Min Yu ◽  
Qing Ji Ying ◽  
Wen Wen Peng ◽  
Chang Zhao Xu ◽  
...  

Agenesis of the dorsal pancreas is a rare congenital pancreatic malformation. We herein describe a 67-year-old woman with a 5-day history of lower back pain who was eventually diagnosed with agenesis of the dorsal pancreas. Abdominal computed tomography showed an enlarged pancreatic head, but the pancreatic body and tail were invisible. The magnetic resonance imaging findings were similar to the computed tomography findings. Magnetic resonance cholangiopancreatography showed that the major pancreatic duct was mildly dilated but otherwise normal. Endoscopic ultrasound revealed absence of the pancreatic body and tail, an enlarged head of the pancreas, and mild pancreatic duct dilation. The final diagnosis was dorsal pancreatic agenesis.


2018 ◽  
Vol 1 (3) ◽  
pp. 28-30
Author(s):  
Tanita Suttichaimongkol

Cholangiocarcinoma is a primary biliary tract tumor arising from the bile duct epithelium. Classically, these tumors have been categorized according to their anatomic location as intrahepatic and extrahepatic. Hilar cholangiocarcinoma is the most common type of extrahepatic cholangiocarcinoma. It is the most difficult cancer to diagnose and therefore carries a poor prognosis with a 5-year survivalrate of less than 10%. Diagnostic imaging, coupled with a high degree of clinical suspicion, play a critical role in timely diagnosis, staging, and evaluation for surgical resectability. The most common imagingmodalities used for diagnosis and staging of hilar cholangiocarcinoma include ultrasound (US), computed tomography (CT), magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP). This article showed a case presentation and reviewed the imaging appearance of hilar cholangiocarcinoma.   Figure 1  Greyscale sonography at the level of hepatic hilum revealed an ill-defined hilar mass (asterisk)resulting in upstream dilatation of right (arrow) and left (arrow head) main intrahepatic duct.  


2018 ◽  
Vol 09 (01) ◽  
pp. 026-031 ◽  
Author(s):  
Manoj Munirathinam ◽  
Pugazhendhi Thangavelu ◽  
Ratnakar Kini

ABSTRACTPancreatico‑pleural fistula is a rare but serious complication of acute and chronic pancreatitis. The pleural effusion caused by pancreatico‑pleural fistula is usually massive and recurrent. It is predominately left‑sided but right‑sided and bilateral effusion does occur. We report four cases of pancreatico‑pleural fistula admitted to our hospital. Their clinical presentation and management aspects are discussed. Two patients were managed by pancreatic endotherapy and two patients were managed conservatively. All four patients improved symptomatically and were discharged and are on regular follow‑up. Most of these patients would be evaluated for their breathlessness and pleural effusion delaying the diagnosis of pancreatic pathology and management. Hence, earlier recognition and prompt treatment would help the patients to recover from their illnesses. Pancreatic pleural fistula diagnosis requires a high index of suspicion in patients presenting with chest symptoms or pleural effusion. Extremely high pleural fluid amylase levels are usual but not universally present. A chest X‑ray, pleural fluid analysis, and abdominal imaging (magnetic resonance cholangiopancreatography/magnetic resonance imaging abdomen more useful than contrast‑enhanced computed tomography abdomen) would clinch the diagnosis. Endoscopic retrograde cholangiopancreatography with stent or sphincterotomy should be considered when pancreatic duct (PD) reveals a stricture or when medical management fails in patients with dilated or irregular PD. Surgical intervention may be indicated in patients with complete disruption of PD or multiple strictures.


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