Cystic form of paraduodenal pancreatitis (cystic dystrophy in heterotopic pancreas (CDHP)): a potential link with minor papilla abnormalities? A study in a large series.

Abstract:

OBJECTIVES:To analyze the association between cystic dystrophy in the heterotopic pancreas (CDHP) and minor papilla abnormalities. MATERIAL AND METHODS:Seventy-six patients with CDHP were retrospectively included over 14 years. Two radiologists searched for MDCT signs of CDHP (cysts and thickened intestinal wall, inflammatory changes), and minor papilla abnormalities (Santorini duct dilatation, luminal calcifications of the minor papilla). Other pancreatic abnormalities (parenchymal calcifications, main pancreatic duct dilatation) or bile duct dilatation were also analysed. RESULTS:CDHP was mostly located in the second part of the duodenum (71/76, 93.5 %). Median duodenal wall thickness was 20 mm (range 10-46). There were multiple cysts in 86 % (65/76, median = 3), measuring 2-60 mm. No cysts were identified in four patients (5 %). Inflammatory changes were found in 87 % (66/76). Minor papilla abnormalities were found in 37 % (28/76) and calcifications in the minor papilla without calcifications in the major papilla were only observed in three patients (4 %). Abnormalities of the pancreas and main bile duct dilatation were identified in 78 % (59/76) and 38 % (29/76). CONCLUSION:Previously described CT features were seen in most patients with CDHP. However, minor papilla abnormalities were seen in a minority of patients and, therefore, do not seem to be a predisposing factor for CDHP. KEY POINTS:Imaging features suggesting a CDHP diagnosis are confirmed in a large series. Minor papilla abnormalities do not seem to be a predisposing factor for CDHP. Most patients did not have any isolated minor papilla abnormalities.

journal_name

Eur Radiol

journal_title

European radiology

authors

Wagner M,Vullierme MP,Rebours V,Ronot M,Ruszniewski P,Vilgrain V

doi

10.1007/s00330-015-3799-8

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

199-205

issue

1

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-015-3799-8

journal_volume

26

pub_type

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