Bifid Pancreatic Tail: an Anatomical Case Series and their Classification

Anomalies and variants of development of the pancreas are relatively frequent. Bifid pancreatic tail is a rare anatomic variation with only a few cases reported in the literature. The present case series were encountered during dissection of 50 anatomical specimens of the pancreas, spleen, and duodenum. We observed four unusual cases (8%) of bifid pancreatic tail. One case was of a vertically oriented bifid pancreas tail (2%), in another case, the tails here horizontally oriented (2%) and in two cases the bifid tails were horizontally oriented but unequal (4%). The bifid tails had an arterial supply that penetrated the glands between the tails and two out of four were also supplied by the superior horizontal pancreatic artery of Popova. The ductal system usually bifurcated at the level of the tails, but a case of trifurcation was also encountered. The current cases should be taken into account in hepato-pancreato-biliary surgery to avoid misdiagnosis and to comprehensively assess the patient preoperatively.

SURGICAL TREATMENT OF HYPERTENSION-DUCTAL TYPE OF CHRONIC PANCREATITIS, IN COMBINATION WITH BILIARY OBSTRUCTION SYNDROME

Background. The frequency of chronic pancreatitis and its complications is steadily increasing, which makes the problem of treating this pathology one of the most urgent and significant. Objective. Improvement of the results of surgical treatment of patients with hypertension-ductal type of chronic pancreatitis with extended stricture of the intrapancreatic part of the common bile duct. Material and methods. During the period 2006–2021, 328 operations were performed in the Grodno University Clinic due to chronic pancreatitis with pathology of the ductal system in combination with pancreatic cysts. The total number of complications was 5,1%. 18 patients with chronic recurrent pancreatitis, ductal hypertension in combination with a cyst of the head pancreas, also with extended stricture of the terminal part common bile duct and mechanical jaundice were operated on according to the methods developed in the clinic: 12 patients underwent choledochopancreatoejunostomy, 5 patients underwent choledochocystopancreatoejunostomy, choledochocystoduodenostomy was performed in 1 case. Results. The developed methods make it possible to perform adequate internal drainage of the ductal system of the pancreas and bile ducts, as well as cystic formations. Conclusions. The application of the developed methods improves the results of surgical treatment complicated chronic pancreatitis.

Sialoliths in Ipsilateral Bartholin`s and Wharton`s Duct: The First Clinical and Ultrasound Report

Sialoliths in sublingual gland is the rarest condition among sialolithiasis in other major salivary glands. Only in 0.4 percent of cases the salivary stone notes in sublingual gland. In our English literature review we count 8 articles which describe sialoliths located within or around the sublingual glands. Nevertheless, in none of those cases a simultaneous sialolithiasis of the submandibular and sublingual gland was noted. Although in one case the authors described a sonogram of sialolith in the sublingual gland, the sonogram of the gland and its ductal system was not presented. Here we present the first ever published clinical and ultrasound report of combined ductal sialolithiasis of sublingual and submandibular glands in a 78-yearold female. Also, Zhang et al`s classification of duct system patterns of the sublingual glands based on 60 cadaveric and 63 clinical cases is analyzed.

Role of the ducktal secretion dysfunction in the pathogenesis of chronic pancreatitis

The review presents an analysis of current scientific data on the role of ductal secretion disorders in the pathogenesis of chronic pancreatitis. It is shown that under the influence of alcohol or other provoking factors, the CFTR transport mechanism of duct cells undergoes damage, which leads to the decrease in the bicarbonate and fluid secretion. Dehydration and acidification contribute to the hyperconcentration of protein and mucous components of pancreatic secretion and to the change in its rheological properties, which complicates further transport through the ductal system. Current conditions are favorable for the formation of mucoprotein plugs and the ductal obstruction that may have an important role in the pathogenesis of chronic pancreatitis at the early stage of development of the disease.

Giant Sialolith of Wharton’s Duct - A Case report with review of literature

Sialolithiasis is the formation of calcific concretions within the parenchyma or ductal system of the major or minor salivary glands, but it most commonly affects the submandibular salivarygland. Sialolithiasis usually occurs in adults aged 30 to 60 years and causes pathognomonicpain during meals. The treatment of sialolithiasis depends on the size and location of thecalculi. In this article we present a case report of giant sialolith in the submandibular salivary duct and review of literature of various diagnostic and treatment aspects. Key Words : Salivary stone, Calculi, submandibular sialolithiasis, sialoadenitis