Periampullary diverticula and pancreaticobiliary disease

Lobo, Dileep N.; Balfour, T. W.; Iftikhar, S. Y.; Rowlands, B. J.

doi:10.1046/j.1365-2168.1999.01121.x

Cited by 135 publications

(127 citation statements)

References 67 publications

(75 reference statements)

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“…Juxtapapillary diverticula arise within a radius of 2-3 cm from the papilla of Vater (2,5). The prevalence of juxtapapillary diverticula increases with age and is reported to be as high as 27% (5).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors hypothesize that a motility disorder of the sphincter of Oddi is related to juxtapapillary diverticulum formation (1)(2)(3)(4)(5)(6). They are commonly associated with concomitant biliary or pancreatic disease, including choledocholithiasis, common bile duct dilatation, cholelithiasis, and pancreatitis.…”

mentioning

confidence: 99%

“…The majority of these patients have imaging findings consistent with choledocholithiasis, cholelithiasis, and/or chronic pancreatitis, which may result from the presence of the juxtapapillary diverticulum (3,5,8,9). Juxtapapillary diverticula can alter cannulation of the papilla at ERCP; therefore, prior detection with MRI and MRCP can aid management planning (7)(8)(9).…”

mentioning

confidence: 99%

“…Juxtapapillary diverticula can alter cannulation of the papilla at ERCP; therefore, prior detection with MRI and MRCP can aid management planning (7)(8)(9). Patients who do not undergo ERCP or endoscopic examination may benefit from the ability of MRI and MRCP to detect these lesions, enabling determination of the etiology of clinical symptomatology and guidance for appropriate clinical management (5,6).…”

mentioning

confidence: 99%

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Juxtapapillary diverticulum: Findings on MRI

Balci¹,

Noone²,

Akun³

et al. 2003

Magnetic Resonance Imaging

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The purpose of our study was to describe the imaging findings of juxtapapillary diverticulum on magnetic resonance imaging (MRI). The MRI and magnetic resonance cholangiopancreatography (MRCP) examinations of 14 patients with juxtapapillary diverticula that were diagnosed on endoscopic retrograde cholangiopancreatography (ERCP) (N ϭ 8) or endoscopy (N ϭ 6) were retrospectively evaluated. T1-weighted spoiled gradient-echo, T2-weighted half Fourier single shot fast spin-echo (HASTE), and T2-weighted True FISP (fast imaging with steady state precession) images and thin-slice MRCP images were obtained on all patients. In five patients, diluted gadolinium DPTA (1/ 100) was used as an oral contrast. T2-weighted True FISP and HASTE images demonstrated air-fluid levels within all diverticula. Hyperintense oral contrast on T1-weighted spoiled gradient-echo images aided detection of the smaller diverticula. MRCP images obtained in the coronal plane best demonstrated the relationship of the diverticula to the papilla. MRI with the use of HASTE, True FISP, and oral contrast-enhanced T1-weighted sequences was able to depict juxtapapillary diverticula in our series.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Juxtapapillary diverticulum: Findings on MRI

Balci¹,

Noone²,

Akun³

et al. 2003

Magnetic Resonance Imaging

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“…3 Primary diverticula usually occur between 50 to 60 years of age. 1,3,4,5,6 These primary diverticula again are classified into external and intramural diverticula. There is no sex predilection in the incidence of diverticula.…”

Section: Introductionmentioning

confidence: 99%

A patient presenting with recurrent post-prandial abdominal discomfort and vomiting

et al. 2015

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Impact of periampullary diverticulum on biliary cannulation: A retrospective cohort study

Seneviratna

Yip

2022

Adv in Digestive Medicine

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The prevalence of periampullary diverticulum (PAD) is relatively high in patients who undergo endoscopic retrograde cholangiopancreatography (ERCP). It is currently unclear if the presence of PAD impacts the success, difficulty, and complication rates of ERCP. The aim of the study is to investigate and compare the success rate, procedure difficulty, and complication rate between patients with or without PAD. Patients with PAD were further analyzed according to location and size. A total of 548 ERCP procedures were performed at our endoscopy center from 2015 to 2016. Those patients with previous ERCP, inability to locate the ampulla or abandoned procedure were excluded. 357 procedures were analyzed. A t test (normally distributed) or Mann‐Whitney U test (skewed) for continuous data and chi‐square or fisher's exact test for categorical data. A total of 116 were found to have PAD. The ampulla was located within the diverticulum in 8.9%, on the edge in 38.9%, and near in 52.2%. 64.3% of the PAD was large and 35.7% small. Patients with PAD were significantly older (P < .001) and more likely to undergo ERCP for common bile duct stone (P = .007). There was no difference in ERCP grade, cannulation difficulty, cannulation success, procedure time, and complication rate between the two groups. Location and size of PAD also did not impact ERCP. The presence of PAD did not affect ERCP cannulation rates, increase the difficulty of cannulation or caused more complications.

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Periampullary diverticula and pancreaticobiliary disease

Abstract: With an ageing population, there will be an increase in elderly patients with PAD and symptomatic pancreaticobiliary disease. Continuing improvements in radiological and endoscopic techniques should enable this vulnerable group to be treated effectively and safely.

Cited by 135 publications

References 67 publications

Juxtapapillary diverticulum: Findings on MRI

Juxtapapillary diverticulum: Findings on MRI

A patient presenting with recurrent post-prandial abdominal discomfort and vomiting

Impact of periampullary diverticulum on biliary cannulation: A retrospective cohort study

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