• Title/Summary/Keyword: 췌관

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Migrated Pancreaticojejunal Stent Forming a Stent-Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report (췌공장 스텐트의 공장으로의 이동으로 발생한 스텐트-돌 복합체 형성과 이로 인한 소장폐색: 증례 보고)

  • Jiwon Kim;Young Han Kim;Byung-Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.512-517
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    • 2023
  • Transanastomotic pancreatic duct stent placement during reconstruction following pancreaticoduodenectomy is widely performed to prevent postoperative pancreatic fistulas and duct stenosis. However, stent-related complications, such as stent occlusion and migration, may occur. Here, we report a rare case of a migrated pancreatic duct plastic stent. After pylorus-preserving pancreaticoduodenectomy, the stent migrated to the jejunum and served as a nidus of the stent-stone complex, which developed jejunal obstruction. The stent-stone complex was removed by explorative laparotomy.

Immunohistochemical study of the pancreatic endocrine cells in the ICR mice (ICR 마우스 췌장 내분비세포에 대한 면역조직화학적 연구)

  • Ku, Sae-kwang;Lee, Hyeung-sik;Lee, Jae-hyun
    • Korean Journal of Veterinary Research
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    • v.42 no.1
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    • pp.21-28
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    • 2002
  • The regional distribution and relative frequency of the pancreatic endocrine cells in the ICR mouse were studied by immunohistochemical (PAP) method using four types of specific antisera against insulin, glucagon, somatostatin and human pancreatic polypeptide (PP). The pancreas of mice could be divided into three portions; pancreatic islets, exocrine and pancreatic ducts. Pancreatic islets, furthermore, were subdivided into three regions (central, mantle and peripheral region) according to their located types of immunoreactive cells. In the pancreatic islet portions, insulin-immunoreactive cells were located in the central and mantle regions but most of somatostatin-, glucagon- and PP-immunoreactive cells were detected in the mantle and peripheral regions with various frequencies. In addition, PP-immunoreactive cells were also found in the central regions of pancreatic islets of ICR mouse. In the exocrine portions, all four types of immunoreactive cells were demonstrated in the ICR mouse. In the pancreatic duct portions, insulin- and glucagon-immunoreactive cells were situated in the epithelial lining of ICR mouse with a few and rare frequencies, respectively. In addition, rare PP-immunoreactive cells were also demonstrated in the subepithelial regions of the pancreatic duct. However, no somatostatin-immunoreactive cells were demonstrated.

Malignant Pancreatic Intraductal Papillary Mucinous Neoplasm with Splenic Invasion: A Case Report (악성 췌관내 유두상 점액성 종양의 비장 침범: 증례 보고)

  • Yeaseul Hur;Young Han Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.795-800
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    • 2024
  • Intraductal papillary mucinous neoplasm (IPMN) is a tumor originating from pancreatic ductal epithelial cells, leading to excessive mucus secretion and dilation of the pancreatic duct. Pathologically, IPMNs display a wide range of dysplasia, ranging from low-grade dysplasia to invasive carcinoma. Invasion into surrounding organs, especially into spleen, is rare and has not been reported in Korean journals. Worldwide, only two cases have been reported. Here, the authors report their experience with a rare case of IPMN in the pancreas that invaded the spleen.

Radiographic Prognostic Criteria of Extracorporeal Shock Wave Lithotripsy for Pancreatic Ductal Stones (체외충격파쇄석술 적용을 위한 췌관결석의 방사선학적 선택)

  • Lee, Won-Hong;Yang, Seon-Wook;Uhm, Joon-Yong;Cho, Cheong-Chan;Ryu, Meung-Sun;Kim, Keon-Chung
    • Journal of radiological science and technology
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    • v.25 no.2
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    • pp.65-70
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    • 2002
  • The pain of chronic pancreatitis associated intraductal stones is related to increased intraductal pressure. Decom-pression of the pancreatic duct along with extraction of stones are the goals of a combined endoscopic-extracorporeal shock wave lithotripsy approach. The aim of this study is to define radiographic prognostic criteria for better complete free rate of pancreatic head and body ductal stones for extracorporeal shock wave lithotripsy. Fifty-nine patients with chronic pancreatitis were treated by extracorporeal shock wave lithotripsy for endoscopically unretrievable stones. The stones on endoscopic retrograde pancreatograms were classified into four characteristics including number, size of longest diameter, density compared with vertebral body, and shape. Complete stone free were obtained in 45 of 59(76.3%). Pancreatic ductal stones with radiographic characteristics including higher density than vertebral body, square shape, and rim calcified stones were hindrance factors for extracorporeal shock wave lithotripsy. We propose that patients with rim calcified stone of our three hindrance factors should be treated by other technique.

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Management Strategy and Surveillance of Intraductal Papillary Mucinous Neoplasm-Gastroenterologist's Viewpoint (췌관 내 유두상 점액종양의 치료 전략과 추적 관찰-소화기내과의 관점)

  • Kim, Tae Hyeon;Chon, Hyung Ku
    • Journal of Digestive Cancer Research
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    • v.9 no.1
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    • pp.1-7
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    • 2021
  • The length, the frequency, and the methods of surveillance for intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debating. According to the recent guidelines, IPMN is stratified into "high-risk stigmata" or absolute indication and "worrisome features" or relative indication as a guide in managing these patients, either those with resection of the lesion or those under surveillance. The risk of malignant transformation was quite low for branch duct-IPMNs without worrisome features or high risk stigmata. However, because the incidence rate of pancreatic cancer in these patients increase linearly with time, continued long-term surveillance is therefore important for patients with low-risk, as well as higher-risk, IPMN. Considering the high prevalence of malignancy, main duct-IPMN should be treated by surgical resection. Among patients with these type IPMNs, segmental dilatation of the main pancreatic duct without any mural nodules and larger than 10 mm of main pancreatic duct might not be immediately resected and need very careful examination and observation. The risk related to a major pancreatic resection must balance the risk of surveillance in patients with IPMN of the pancreas who have co-morbidity and are elderly.

Hereditary Pancreatitis - Report of a Kindred - (유전성 췌장염 - 1가계보고 -)

  • Kim, Hyoung-Ran;Chung, Jae-Hee;Song, Young-Tack;Yoon, Won-Jae;Ryu, Ji-Kon;Kim, Yong-Tae
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.24-31
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    • 2006
  • Hereditary pancreatitis (HP) appears as an autosomal dominant trait. If the patient has (1) more than 2 affected relatives in different generations and (2) no known etiological factors such as alcohol or gallstones, or has R122H or N29I mutation in the cationic trypsinogen (CT) gene, the diagnosis of HP can be applied. Risk of pancreatic cancer is estimated to be 53-fold higher than in a general population after the age of 50 years. We report a kindredof HP, involving three of its family together; two siblings (14 years old, 13 years old) and cousin (26 years old). The patient had complicating chronic pancreatitis and pancreatic stone, and was treated with amodified Puestow-Gillesby procedure. Her sisters showed chronic pancreatitis. Her cousin underwent a drainage procedure of the pancreatic duct for chronic pancreatitis during the high school period. All the three members showed the R122H mutation of the CT gene.

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