Browsing by Author "Ugljesic, M. (6701730451)"

It has been well established that chronic pancreatitis, initially localized to small ducts, evolves later to the main duct and the whole gland. The aim of this study was to give a morphologically based insight on borderline cases of incipient pancreatitis. A total of 95 human autopsy specimens were suspected for chronic pancreatitis on basis of positive history and macroscopic appearance. They were studied by standard anatomical methodology: H and E staining, postmortem pancreatography, corrosion casting, Spalteholz diaphanoscopy, macro- and microdissection. Various stages of chronic pancreatitis were verified in 87 specimens (91.6%). The initial (incipient, or 'equivocal') pancreatitis, based on Marseilles and Cambridge criteria, were detected in 16 cases (18.4%). The ductal abnormalities were found in only one (11 specimens) or in two (5 specimens) main pancreatic duct primary tributaries, without any involvement of the surrounding ducts and parenchyma. The pathological ducts were most frequently situated in the head, and to a lesser extent, in the body and tail of pancreas (10, 4 and 2 cases, respectively). These ducts were significantly both dilated and elongated (mean calibre 1.21 mm, mean length 15.7 mm). In conclusion, a precise diagnosis of the initial chronic pancreatitis has to be based on a full visualization and adequate morphometry of all the main pancreatic duet's tributaries, with clear-cut values of their normal dimension range.

An analysis of 119 autopsy specimens of human pancreas revealed two cases of specific embryonic anomaly, which we named ventral pancreas pseudoagenesis. Both glands underwent ductography and ductal morphometry, with subsequent histological assessment. They were of usual shape, contours and topographic regions. In both cases global gland drainage was via the minor papilla, while the major papilla was the outlet of common bile duct only. The morphological analysis revealed ductal indices to be similar to those found in dorsal pancreas divisum. One of the specimens had mild and the other marked chronic pancreatitis, which was probably due to the difference in age. In conclusion, ventral pancreas pseudoagenesis is another variant of pancreatic malformation which has to be taken into account in interpreting ERCPs of patients with chronic pancreatitis of unknown origin.