Abstract:
:Reflux of biliary secretions into the pancreatic duct following gallstone obstruction of the common biliary pancreatic ampulla has been implicated as a cause of acute pancreatitis. However, the pancreatic duct pressure is higher than the biliary pressure and, therefore, the simple obstruction of the choledochoduodenal junction by one gallstone does not result in biliary pancreatic reflux. We propose a mechanism whereby simultaneous migration and sequential impaction above and below the common biliary pancreatic ampulla of two gallstones allows for the creation of a toxic bile-pancreatic juice mixture in the common bile duct, subsequent reversal of the pressure gradient and reflux of the toxic secretions into the pancreatic duct.
journal_name
Med Hypothesesjournal_title
Medical hypothesesauthors
Arendt T,Mönig H,Stüber E,Katsoulis S,Fölsch URdoi
10.1054/mehy.1998.0896keywords:
subject
Has Abstractpub_date
2000-04-01 00:00:00pages
570-3issue
4eissn
0306-9877issn
1532-2777pii
S0306-9877(98)90896-9journal_volume
54pub_type
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