Calcifying obstructive pancreatitis: a study of intraductal papillary mucinous neoplasm associated with pancreatic calcification Mauricio Zapiach, Dhiraj.

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Presentation transcript:

Calcifying obstructive pancreatitis: a study of intraductal papillary mucinous neoplasm associated with pancreatic calcification Mauricio Zapiach, Dhiraj Yadav, Thomas C Smyrk, Joel G Fletcher, Randall K Pearson, Jonathan E Clain, Michael B Farnell, Suresh T Chari Clinical Gastroenterology and Hepatology Volume 2, Issue 1, Pages 57-63 (January 2004) DOI: 10.1016/S1542-3565(03)00292-1

Figure 1 Non-contrast CT scan showing extensive pancreatic calcification in a patient (no. 2) with a small IPMN in the head of the pancreas. ERCP showed dilated pancreatic duct with mucin pouring out of the ampulla. Clinical Gastroenterology and Hepatology 2004 2, 57-63DOI: (10.1016/S1542-3565(03)00292-1)

Figure 2 ERCP showing a dilated pancreatic duct with multiple intraductal stones. Prior to referral to Mayo, patient (no. 1) was diagnosed with chronic pancreatitis and treated with stenting of pancreatic duct stricture and extracorporeal shockwave lithotripsy for dissolution of stones. Clinical Gastroenterology and Hepatology 2004 2, 57-63DOI: (10.1016/S1542-3565(03)00292-1)

Figure 3 (A and B) Calcification in peripherally located small ducts. (B) There is also duct wall calcification. Note that there is no IPMN associated with the calcification. Clinical Gastroenterology and Hepatology 2004 2, 57-63DOI: (10.1016/S1542-3565(03)00292-1)

Figure 4 (A) Intraluminal and (B) duct wall calcification. (A) Squamous metaplasia is seen in adjacent duct. Pancreatic ducts shown were located remotely from the region of pancreas involved by IPMN. Clinical Gastroenterology and Hepatology 2004 2, 57-63DOI: (10.1016/S1542-3565(03)00292-1)