Pancreatitis associated with pancreaticobiliary maljunction.
OBJECTIVE
Pancreaticobiliary maljunction is a rare anomaly, but causes various pathological conditions in the biliary tract and the pancreas. This study aims at clarifying the features of pancreatitis associated with pancreaticobiliary maljunction.


METHODS
A total of 100 patients with pancreaticobiliary maljunction were reviewed. Clinical findings and cholangiopancreatographic results in patients with acute or chronic pancreatitis associated with pancreaticobiliary maljunction were analyzed.


RESULTS
Of 100 patients, 14 had pancreatic disorders: acute pancreatitis (n = 3), chronic pancreatitis (n = 5), hyperamylasemia (n = 4), and pancreatic carcinoma (n = 2). The acute pancreatitis was mild (n = 3) and relapsing (n = 2). In patients with chronic pancreatitis, pancreatic stones (n = 2) and radiolucent protein plugs (n = 2) were detected only in the dilated common channel or in the main pancreatic duct near the common channel. Two patients received cyst-duodenostomy in the infant developed chronic pancreatitis 11 and 27 years later.


CONCLUSIONS
Acute or chronic pancreatitis was sometimes associated with pancreaticobiliary maljunction. These pancreatitis cases showed different clinical and pancreatographic findings from others. These differences might be due to the peculiar mechanism that they were induced by bile reflux into the pancreatic duct via the anomalous connection.
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Honkomagome 3-18-22, Bunkyo-ku, 113-8677 Tokyo, Japan. kamisawa-k@komagome-hospital.bunkyo.tokyo.jp
Terumi
T
Kamisawa
Masakatsu
M
Matsukawa
Kozue
K
Amemiya
Yuyang
Y
Tu
Naoto
N
Egawa
Atsutake
A
Okamoto
Syu
S
Aizawa
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities*; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities*; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies