title: Air in the main pancreatic duct: a case of innocent air.
abstract: Air in the main pancreatic duct has been reported only rarely and might be associated with either a spontaneous or a surgically induced alteration of the anatomy of the biliary tract. We report a case of "innocent" air found incidentally in the main pancreatic duct. To our knowledge, this is only the third such case reported. A 54-year-old woman presented with hemoptysis that had lasted for 3 d. She underwent a chest computed tomography scan, which revealed not only focal bronchiectasis in the left lower lobe, but also air in the main pancreatic duct and dilatation of the common bile duct. She was managed conservatively for the hemoptysis and no further problems developed. She had no specific gastrointestinal symptoms and had no history of surgery or medication. Her laboratory parameters were normal. Magnetic resonance cholangiopancreatography also demonstrated air in the main pancreatic duct and a dilated common bile duct (CBD). Duodenoscopy revealed separate biliary and pancreatic orifices with patulous openings and some air bubbles appearing in the pancreatic orifice. Endoscopic retrograde cholangiopancreatography (ERCP) showed the dilated CBD and pancreatic duct with some air bubbles, but no other abnormal lesions. She was discharged with no further problems. Most patients with air in the main pancreatic duct have had a pancreatobiliary disease, or a history of pancreatobiliary disease, pancreatobiliary surgery or sphincterotomy. If the air is innocent, as in our case, ERCP should be performed to evaluate any altered sphincteric function or anatomy such as patulous openings.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu 480717, South Korea.
authors.forename: Yun Ji
authors.initials: YJ
authors.lastname: Kim
authors.forename: Hyung Keun
authors.initials: HK
authors.lastname: Kim
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Cho
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Hiun Suk
authors.initials: HS
authors.lastname: Chae
authors.forename: Seung Kyong
authors.initials: SK
authors.lastname: Kim
authors.forename: Eun Sun
authors.initials: ES
authors.lastname: Kim
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000388:Air; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003135:Common Bile Duct / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D006469:Hemoptysis; D006801:Humans; D008875:Middle Aged; D010183:Pancreatic Ducts; D014057:Tomography, X-Ray Computed