title: Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations.
abstract: BACKGROUND
  Only one case of santorinicele without pancreas divisum pathophysiology (SWOPP) was previously reported. The purpose of the study was to determine the gross prevalence of SWOPP and santorinicele with pancreas divisum (SWPD) in community and patient populations, and investigate their clinical and radiographic features.
  
  
  METHODS
  This cross-sectional study was performed at a tertiary referral centre. The Patient group comprised 2035 consecutive patients enrolled in the study who underwent magnetic resonance cholangiopancreatography (MRCP) studies. The Community group comprised 2905 consecutive subjects who participated in our whole-body medical check-up program that routinely includes MRCP studies. SWOPP was diagnosed when a saccular dilatation of the terminal portion of the dorsal pancreatic duct was observed unaccompanied by pancreas divisum or dominant dorsal duct. The prevalence of SWOPP and SWPD, and the clinical and radiological features were assessed in each group.
  
  
  RESULTS
  Five cases of SWOPP were found in the Patient group (age range, 67-85 years; mean age, 73.6 years) (5/2035 = 0.25%; 95% confidence interval, 0.07-0.57); there were no cases of SWOPP in the Community group (0/2905 = 0.00%; 95% confidence interval, 0.00-0.10) (P = 0.01). Previous history of pancreatitis (4/5) and chronic pancreatitis (3/5) was more common in patients with SWOPP than in other subjects in the Patient or Community groups (both P < 0.05). Two cases of SWOPP were accompanied by reverse-Z type meandering main pancreatic duct. Six cases of SWPD were found. These cases were asymptomatic in 4/6, had a larger santorinicele (6.9 mm) than SWOPP patients (4.5 mm; P = 0.02), and were not associated with pancreatitis (0/6).
  
  
  CONCLUSIONS
  The second to sixth reported cases of SWOPP were presented. SWOPP is a relatively rare condition found mostly in patients suffering pancreatitis, especially chronic pancreatitis, and may be an acquired condition. Santorinicele is not always accompanied by pancreas divisum.
authors.forename: Wataru
authors.initials: W
authors.lastname: Gonoi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Akai
authors.forename: Kazuchika
authors.initials: K
authors.lastname: Hagiwara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Akahane
authors.forename: Naoto
authors.initials: N
authors.lastname: Hayashi
authors.forename: Eriko
authors.initials: E
authors.lastname: Maeda
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kiryu
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Kansei
authors.initials: K
authors.lastname: Uno
authors.forename: Naoki
authors.initials: N
authors.lastname: Okura
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D049448:Cholangiopancreatography, Magnetic Resonance; D003430:Cross-Sectional Studies; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000473:pathology*; D015995:Prevalence; D011859:Radiography; D055815:Young Adult