Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy

Boninsegna, Enrico; Manfredi, Riccardo; Ventriglia, Anna; Negrelli, Riccardo; Pedrinolla, Beatrice; Mehrabi, Sara; Gabbrielli, Armando; Mucelli, Roberto Pozzi

doi:10.1007/s00330-015-3644-0

Cited by 23 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The description of the ductal anatomy is similar to what is described on CT images[63]. Cystic dilation of the terminal dorsal duct near the opening of the minor papilla described as a “Santorinicele” can also be visualized on an S-MRCP[73, 74].…”

Section: Symptomatology and Diagnosismentioning

confidence: 99%

Identification and management of pancreas divisum

Gutta

Fogel

Sherman

2019

Expert Review of Gastroenterology & Hepatology

View full text Add to dashboard Cite

Pancreas divisum, the most common congenital malformation of the pancreas, occurs due to a failure of fusion of the ductal systems of the dorsal and ventral pancreatic buds in the seventh week of intra-uterine life. This leads to a dominant dorsal pancreatic duct draining though the minor papilla and a small ventral pancreatic duct draining through the major papilla. The prevalence in western populations is about 10% and more than 95% of these patients are without pancreatic symptoms, with the anomaly found incidentally on abdominal imaging for an unrelated indication. The etiological role and clinical significance of pancreas divisum in relation to pancreatic disease has not yet been clearly defined, but may predispose to pancreatic disease in co-existence with other factors. Secretin-enhanced Magnetic Resonance Cholangiopancreatography is the non-invasive imaging modality of choice to identify pancreas divisum. Patients may be offered minor papilla therapy when they present with recurrent acute pancreatitis, severe acute pancreatitis and can be considered for therapy in the setting of chronic pancreatitis and chronic abdominal pain of pancreatic origin. Minor papilla endotherapy (sphincterotomy and/or stenting) via Endoscopic Retrograde Cholangiopancreatography and minor papilla surgical therapy have comparable outcomes with endotherapy typically considered first-line due to a favorable adverse event profile. The response to therapy is variable with maximal benefit seen in patients with recurrent acute pancreatitis and least with chronic pancreatic-type abdominal pain. Data supporting either therapy are of low quality as they are predominantly retrospective with a sub-optimal follow up period. Surgical options including a pancreatojejunostomy (Puestow or Frey procedure) or a total pancreatectomy with auto-islet cell transplantation may be considered in a subset of patients.

show abstract

Section: Symptomatology and Diagnosismentioning

confidence: 99%

Identification and management of pancreas divisum

Gutta

Fogel

Sherman

2019

Expert Review of Gastroenterology & Hepatology

View full text Add to dashboard Cite

show abstract

“…Even in the absence of increased sphincter tone, pancreatic secretions may suffice to distend the PD. 85 (Figure 16)…”

Section: Groove Pancreatitis (Gp)mentioning

confidence: 99%

The clinical value of secretin-enhanced MRCP in the functional and morphological assessment of pancreatic diseases

Chamokova

Bastati

Poetter-Lang

et al. 2018

The British Journal of Radiology

View full text Add to dashboard Cite

Secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) provides a non-invasive way, with which, to evaluate pancreatic duct (PD) anatomy and exocrine pancreatic function. S-MRCP can be added to the routine pancreas MR examination in equivocal cases. Moreover, it can detect subtle PD involvement, allowing diagnosis of early, rather than end-stage, pancreatic diseases. Although S-MRCP is a valuable non-invasive diagnostic method, it is only performed in a few centres due to relative high cost. Furthermore, less familiarity with its indications, the examination technique, and image interpretation also contribute to its limited use. Thus, the purpose of this article is to explain secretin's mechanism of action, the examination technique, the clinically relevant indications, the advantages, and limitations. Finally, we will focus on image analysis and its role in achieving an early and accurate diagnosis of specific pancreatic and PD diseases.

show abstract

“…PD incidence is different and depends on the investigated population and the methods used. It can be diagnosed in 5-11% by magnetic resonance cholangiopancreatography (MRCP) [22][23][24][25], 9-16.8% secretin MRCP [23,24,26], 0.47-2.3% endoscopic retrograde cholangiopancreatography (ERCP) [27,28], 13.6% by endoscopic ultrasound (EUS) [29], 4-14% autopsy [27,30]. Besides, the overall endoscopic detection rate for PD seems to be higher in some parts of the world.…”

Section: Incidence and Classificationmentioning

confidence: 99%

Pancreas divisum: a reemerging risk factor for pancreatic diseases

Covanţev

2018

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. The attention towards the PD has grown significantly since there are reports that this condition may cause acute relapsing pancreatitis, chronic pancreatitis and chronic abdominal pain syndrome. Furthermore, over the years, there have been multiple reports of PD associated with different types of tumors. There is evidence that PD can be associated with pancreatic tumors (up to 12.5% of cases). The golden standard for diagnosing PD is endoscopic retrograde cholangiopancreatography, but since it is an invasive procedure magnetic resonance cholangiopancreatography with secretin is a good alternative. In case the patient is symptomatic, endoscopic or surgical treatment should be performed. This review describes the key points of the pathophysiology, diagnostic modalities, risks of pancreatitis and tumors, as well as treatment options of PD.

show abstract

Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy

Cited by 23 publications

References 25 publications

Identification and management of pancreas divisum

Identification and management of pancreas divisum

The clinical value of secretin-enhanced MRCP in the functional and morphological assessment of pancreatic diseases

Pancreas divisum: a reemerging risk factor for pancreatic diseases

Contact Info

Product

Resources

About