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Main duct lesion is the segmental or diffuse dilatation of main pancreatic duct greater than 5 mm without other causes of obstruction. Meanwhile, branch duct lesion is the pancreatic cyst more than 5 mm that communicates with the main duct. The mixed duct lesions fulfills both criteria above. [10]
A Puestow procedure is indicated for the treatment of symptomatic chronic pancreatitis patients with pancreatic ductal obstruction and a dilated main pancreatic duct. The main pancreatic duct needs to be 6mm in diameter in the body of the pancreas for this procedure to be possible.
In 2002, the Japanese Pancreas Society proposed the following diagnostic criteria for autoimmune pancreatitis: [9] I. Pancreatic imaging studies show diffuse narrowing of the main pancreatic duct with irregular wall (more than 1/3 of length of the entire pancreas). II.
The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan. [9] Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people. [10] Pancreatic ductal carcinoma is a common form of pancreatic cancer.
[3] [12] A biopsy of the pancreas is not required for the diagnosis. [3] On imaging, pancreatic and bile duct dilatation, atrophy of the pancreas, multiple calcifications of the pancreas, and enlargement of pancreatic glands can be found. [12] On MRI scan, there is a low T1 signal due to inflammation, fibrosis, focal lesions, and calcifications.
The human embryo begins life with two ducts in the pancreas, the ventral duct and the dorsal duct. Normally, the two ducts will fuse together to form one main pancreatic duct; this occurs in more than 90% of embryos. In approximately 10% of embryos the ventral and dorsal ducts fail to fuse together, resulting in pancreas divisum.
Generally, diseases outlined within the ICD-10 codes K85-K86 within Chapter XI: Diseases of the digestive system should be included in this category. Wikimedia Commons has media related to Diseases and disorders of pancreas .
Cyst size greater than 3 cm, main pancreatic duct dilation of 5-10 mm, or a change in caliber or a narrowing of the main pancreatic duct with atrophy of the duct distally, presence of lymph node swelling, thickened or enhancing cyst walls, or an increase in cyst size over a year are considered intermediate risk imaging findings for cancer. [1]