The clinical significance of papillitis of the major duodenal papilla.
BACKGROUND
This study investigated the clinical significance of papillitis of the major duodenal papilla and analyzed the correlation between endoscopic and histologic papillitis in patients with biliary or pancreatic disorders.


METHODS
Eighty-seven patients and 12 healthy control subjects were enrolled. The endoscopic appearance of papillitis was classified by two blinded endoscopists, and biopsy specimens were taken of the papilla. Various factors were prospectively analyzed to identify any relationship with the endoscopic severity of the papillitis.


RESULTS
By univariate analysis, a clinically acute inflammatory condition and elevation of serum transaminase levels were significantly associated with moderate and severe endoscopic papillitis (p < 0.05). However, by multivariate analysis, only a clinically acute inflammatory condition was significantly associated with moderate and severe endoscopic papillitis (p < 0.001). The endoscopic severity of papillitis was poorly correlated with monocyte infiltration, but there was a good correlation with neutrophil infiltration. Moderate and severe papillitis were not observed in healthy volunteers.


CONCLUSIONS
Moderate and severe endoscopic papillitis were significantly more common in patients with biliary or pancreatic disorders plus a clinically acute inflammatory condition, whereas moderate and severe papillitis were not observed in healthy volunteers. Moderate and severe endoscopic papillitis are characteristic of biliary or pancreatic disorders.
Park
Ju Sang
JS
Department of Internal Medicine and Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Myung-Hwan
MH
Lee
Sung Koo
SK
Seo
Dong Wan
DW
Lee
Sang Soo
SS
Chang
Hye-Sook
HS
Han
Jimin
J
Kim
Jung-Sun
JS
Min
Young Il
YI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology*; D001649:Bile Duct Diseases / Q000150:complications* / Q000473:pathology*; D001707:Biopsy, Needle; D002761:Cholangitis / Q000150:complications* / Q000473:pathology*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications* / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index