title: Cystic form of paraduodenal pancreatitis (cystic dystrophy in heterotopic pancreas (CDHP)): a potential link with minor papilla abnormalities? A study in a large series.
abstract: OBJECTIVE
  To analyze the association between cystic dystrophy in the heterotopic pancreas (CDHP) and minor papilla abnormalities.
  
  
  METHODS
  Seventy-six patients with CDHP were retrospectively included over 14 years. Two radiologists searched for MDCT signs of CDHP (cysts and thickened intestinal wall, inflammatory changes), and minor papilla abnormalities (Santorini duct dilatation, luminal calcifications of the minor papilla). Other pancreatic abnormalities (parenchymal calcifications, main pancreatic duct dilatation) or bile duct dilatation were also analysed.
  
  
  RESULTS
  CDHP was mostly located in the second part of the duodenum (71/76, 93.5 %). Median duodenal wall thickness was 20 mm (range 10-46). There were multiple cysts in 86 % (65/76, median = 3), measuring 2-60 mm. No cysts were identified in four patients (5 %). Inflammatory changes were found in 87 % (66/76). Minor papilla abnormalities were found in 37 % (28/76) and calcifications in the minor papilla without calcifications in the major papilla were only observed in three patients (4 %). Abnormalities of the pancreas and main bile duct dilatation were identified in 78 % (59/76) and 38 % (29/76).
  
  
  CONCLUSIONS
  Previously described CT features were seen in most patients with CDHP. However, minor papilla abnormalities were seen in a minority of patients and, therefore, do not seem to be a predisposing factor for CDHP.
  
  
  CONCLUSIONS
  Imaging features suggesting a CDHP diagnosis are confirmed in a large series. Minor papilla abnormalities do not seem to be a predisposing factor for CDHP. Most patients did not have any isolated minor papilla abnormalities.
authors.affiliation: Radiology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, APHP, University Hospitals Paris Nord Val de Seine, 100, Bd du Général Leclerc, 92110, Clichy, France. wagner.mathilde@gmail.com.|INSERM, UMR 1149, Paris Diderot University, Paris, France. wagner.mathilde@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Radiology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, APHP, University Hospitals Paris Nord Val de Seine, 100, Bd du Général Leclerc, 92110, Clichy, France.
authors.forename: M P
authors.initials: MP
authors.lastname: Vullierme
authors.affiliation: INSERM, UMR 1149, Paris Diderot University, Paris, France.|Gastroenterology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, APHP, University Hospitals Paris Nord Val de Seine, Clichy, France.
authors.forename: V
authors.initials: V
authors.lastname: Rebours
authors.affiliation: Radiology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, APHP, University Hospitals Paris Nord Val de Seine, 100, Bd du Général Leclerc, 92110, Clichy, France.|INSERM, UMR 1149, Paris Diderot University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ronot
authors.affiliation: INSERM, UMR 1149, Paris Diderot University, Paris, France.|Gastroenterology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, APHP, University Hospitals Paris Nord Val de Seine, Clichy, France.
authors.forename: P
authors.initials: P
authors.lastname: Ruszniewski
authors.affiliation: Radiology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, APHP, University Hospitals Paris Nord Val de Seine, 100, Bd du Général Leclerc, 92110, Clichy, France.|INSERM, UMR 1149, Paris Diderot University, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000000981:diagnostic imaging / Q000473:pathology; D002828:Choristoma; D003937:Diagnosis, Differential; D004378:Duodenal Diseases; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010179:Pancreas / Q000000981:diagnostic imaging; D010181:Pancreatic Cyst / Q000150:complications / Q000175:diagnosis*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies
keywords: Cystic dystrophy in the heterotopic pancreas; Minor papilla; Multidetector computed tomography; Pancreatitis; Paraduodenal pancreatitis