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EN
There are many anatomic variations of pancreatic duct and congenital anomalies of pancreas, which have been described in the literature. Most of them has no clinical significance and is used to be incidentally discovered in radiological examinations. We have demonstrated in our paper that the most frequent anatomical variations of pancreatic duct in the patients with pancreatic diseases are pancreas divisum as well as ansa pancreatica.
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2018
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vol. 1
|
issue 1
63-66
EN
There are many anatomic variations of pancreatic duct and congenital anomalies of pancreas, which have been described in the literature. Most of them has no clinical significance and is used to be incidentally discovered in radiological examinations. We have demonstrated in our paper that the most frequent anatomical variations of pancreatic duct in the patients with pancreatic diseases are pancreas divisum as well as ansa pancreatica.
EN
The authors presented a case of 62-year old caucasian race male patient that was repeatedly admitted to hospitals, in 3 last years, with exacerbations of the chronic pancreatitis. During two last hospitalisations, according to the ERCP examination and high level of CEA and Ca 19.9 in pancreatic juice, a hypothesis of IPMN was put. Patient underwent a distal pancreatectomy with splenectomy. Postoperative specimen examination revealed dilated Wirsung duct in distal part of the pancreas. Small cysts and multiple papillas in the lumen of MPD were found. Microscopy reveal Intraductal Papillary Mucinous Neoplasm with medium grade dysplasia without cancer.When we confronted the reported case with available literature, we found that IPMN is not a frequent cause of recurrent pancreatitis, but those patiets require separate treatment strategy to other chronic pancreatitis patients.
EN
The paper presents description of the effective treatment of patients with extensive consequences of necrotizing pancreatitis. The strategy of treatment was to extend access to necrotic areas („step-up approach”). Applied endoscopic transmural access (transgastric), percutaneous access (transperitoneal) and surgical access. The cooperation endoscopist, surgeon and interventional radiologist gave very beneficial clinical effects in patients with extensive complications of acute pancreatitis.
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