| Spontaneous flow of bile through the human pancreatic duct in the absence of pancreatitis: nature's human experiment. | |
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MedLine Citation:
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PMID: 14648423 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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One hundred years ago E. L. Opie proposed two distinct hypotheses to address the pathogenesis of gallstone-induced pancreatitis. These hypotheses appear mutually exclusive. The first predicts that impediment to the flow of pancreatic juice causes pancreatitis (the pancreatic duct obstruction hypothesis), whereas the second predicts that bile flow into the pancreatic duct behind an impacted gallstone would trigger the onset of acute pancreatitis (the common-channel hypothesis). One of the more convincing arguments against the latter hypothesis is the observation that bile, when experimentally perfused through the pancreatic duct of dogs, does not induce pancreatitis. This experimental situation had spontaneously developed in the patient we describe here: a biliopancreatic fistula had permitted the continuous flow of bile through a large portion of the pancreas, which was associated with cholangitis but had apparently never led to pancreatitis. This patient's case would suggest that in humans, just as in experimental animals, bile flow through the pancreatic duct is not necessarily involved in the onset of gallstone-induced pancreatitis and lends further support to Opie's pancreatic duct obstruction hypothesis. |
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Authors:
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T Pohle; J W Konturek; W Domschke; M M Lerch |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Endoscopy Volume: 35 ISSN: 0013-726X ISO Abbreviation: Endoscopy Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-12-03 Completed Date: 2004-03-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0215166 Medline TA: Endoscopy Country: Germany |
Other Details:
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Languages: eng Pagination: 1072-5 Citation Subset: IM |
Affiliation:
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Department of Medicine B, University of Münster, Münster, Germany. pohlet@uni-muenster.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Bile / physiology* Bile Ducts / abnormalities Biliary Fistula / diagnosis Cholangiopancreatography, Endoscopic Retrograde Common Bile Duct / pathology Dilatation, Pathologic Female Gallstones / complications Humans Pancreatic Ducts* Pancreatic Fistula / diagnosis Pancreatitis / etiology, physiopathology* |
| Comments/Corrections | |
Comment In:
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Endoscopy. 2004 Sep;36(9):830-1; author reply 831
[PMID:
15326580
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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