title: The clinical significance of papillitis of the major duodenal papilla.
abstract: 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.
authors.affiliation: Department of Internal Medicine and Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ju Sang
authors.initials: JS
authors.lastname: Park
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Seo
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Hye-Sook
authors.initials: HS
authors.lastname: Chang
authors.forename: Jimin
authors.initials: J
authors.lastname: Han
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Young Il
authors.initials: YI
authors.lastname: Min
mesh_terms: 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