Learning objectives
It is often said that if God doesn't love variety,
why is there so much of it?
Recognition of variant morphology is one of the cornerstones of radiology,
without a sound knowledge of which a trainee struggles to become an astute radiologist.
This exhibit aims at:
Discussing a wide spectrum of normal variants,congenital anomalies and pseudolesions of the pancreas and its ductal system.
The cross-sectional imaging appearances are illustrated with emphasis on the most appropriate imaging technique for each condition.
The clinical implications and manifestations...
Background
THE PANCREAS
Without history humans are demoted to lower animals....
Did you know....?
Pancreas was first discovered by Herophilus,
a Greek anatomist and surgeon (born in 336 BC).
Four hundred years later,
Ruphos,
in the 1st or 2nd Century AD,
an anatomist–surgeon of Ephesus,
gave the name ‘pancreas’.
Writing in Greek,
the word meant ‘all flesh’.
Johann Georg Wirsüng,
a German émigré,
discovered the pancreatic duct in Italy,
in 1642,
thereby initiating the study of the pancreas.
Pancreas as a secretory organ was investigated by...
Imaging findings OR Procedure details
Pancreatic developmental malformations can be divided into: migration anomalies,
fusion anomalies,
and duplication anomalies.Ectopic pancreas and annular pancreas represent migration anomalies.
Pancreas contour variations,
including a pancreas divisum and a variable lateral contour of the pancreatic head,
represent fusion anomalies,
whilst a bifid tail of the pancreas represents a type of duplication anomaly.
The spectrum of variants and anomalies discussed include:
Dorsal Agenesis – complete and partial
Annular pancreas – complete and partial
Circumportal pancreas (portal annular pancreas)
Arterial annular pancreas
Pancreas divisum
Ansa pancreatica...
Conclusion
Recognition of variant & anomalous anatomy on imaging provides a great learning platform for reviewing common morphology and embryogenesis of the pancreas,
and yields insight into the potential medical,
radiologic,
and surgical implications.
These anatomic variants and developmental anomalies of the pancreas can be important; some of which can pose medical problems or a diagnostic challenge,
while others may render surgical treatment more intricate.
Familiarity with the imaging features is important to establish the correct diagnosis and determine appropriate treatment,
which is critical to avoid...
References
Alexander LF.
Congenital pancreatic anomalies,
variants,
and conditions.
Radiol Clin North Am.
2012 May;50(3):487-98.
doi: 10.1016/j.rcl.2012.03.006.
Tadokoro H,
Takase M,
Nobukawa B.
Development and congenital anomalies of the pancreas.
Anat Res Int.
2011;2011:351217.
doi: 10.1155/2011/351217.
John M.
Howard (Toledo,
Ohio).
History of the Pancreas. http://pancreasclub.com/home/pancreas.
Hernandez-Jover D,
Pernas JC,
Gonzalez-Ceballos S,
Lupu I,
Monill JM,
Pérez C.
Pancreatoduodenal junction: review of anatomy and pathologic conditions.
J Gastrointest Surg.
2011 Jul;15(7):1269-81.
doi: 10.1007/s11605-011-1443-8.
Nijs EL,
Callahan MJ.
Congenital and developmental pancreatic anomalies: ultrasound,
computed tomography,
and...
Personal Information
Ankur Arora,
MD,
DNB,
FRCR,
EDiR
Assistant Professor (Radiology/ Interventional Radiology)
Institute of Liver & Biliary Sciences (ILBS)
New Delhi,
India
Email:
[email protected]
Acknowledgements