Document Detail

Clinical and morphological features of duodenal cystic dystrophy in heterotopic pancreas.
MedLine Citation:
PMID:  17324133     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Cystic dystrophy in heterotopic pancreas (CDHP) is an uncommon complication of pancreatic heterotopia, only described in surgical series, whose natural history is not known. The aim of this study was to determine clinical and morphological features of CDHP in a medical-surgical series of patients and to ascertain the relationship of CDHP with chronic pancreatitis (CP) in the pancreas proper. METHODS: All patients who had duodenal CDHP diagnosed radiologically both with CT scan and endoscopic ultrasonography between 1995 and 2004 were included. The diagnosis was confirmed by surgical specimens when available. RESULTS: One hundred five patients were included (91% men, 86% chronic alcoholic) with a median follow-up of 15 months. The median age at first symptoms was 46 yr. CDHP was associated with CP in the pancreas proper in 71% of patients. Presenting symptoms were pancreatic pain (91%), severe weight loss (73%), acute pancreatitis (45%), vomiting (30%), steatorrhea (23%), diabetes mellitus (20%), jaundice (13%), and upper gastrointestinal hemorrhage (5%). Cysts were multiple in 75% (median 3). The median diameter of the largest cyst was 10 mm. Endoscopy was normal in 36% of patients and showed duodenal stenosis in 52% (complete 6%, incomplete 46%). Surgical treatment was necessary in only 27% of patients (Whipple procedure 16%). CONCLUSIONS: CDHP may arise in patients with or without CP and with or without chronic alcoholism. Symptoms may be severe but warrant surgery in less than one-third of patients.
Vinciane Rebours; Philippe Lévy; Marie-Pierre Vullierme; Anne Couvelard; Dermot O'Toole; Alain Aubert; Laurent Palazzo; Alain Sauvanet; Pascal Hammel; Frédérique Maire; Philippe Ponsot; Philippe Ruszniewski
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Publication Detail:
Type:  Journal Article     Date:  2007-02-23
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  102     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-02     Completed Date:  2007-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  871-9     Citation Subset:  IM    
Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie, Hôpital Beaujon, AP-HP, Clichy, France.
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MeSH Terms
Chi-Square Distribution
Choristoma / pathology*,  radiography,  surgery,  ultrasonography
Cysts / pathology*,  radiography,  surgery,  ultrasonography
Duodenal Diseases / pathology*,  radiography,  surgery,  ultrasonography
Endoscopy, Gastrointestinal
Middle Aged
Risk Factors
Tomography, X-Ray Computed

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