Limits...
Heterotopic Pancreas within the Proximal Hepatic Duct, Containing Intraductal Papillary Mucinous Neoplasm.

Lawrence AJ, Thiessen A, Morse A, Shapiro AM - Case Rep Surg (2015)

Bottom Line: We report a unique first case of benign heterotopic pancreas arising within the proximal hepatic bile duct, containing a focus of intraductal papillary mucinous neoplasm (IPMN).The condition was diagnosed on pathological explant after left hepatic lobectomy with total extrahepatic bile duct excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7.

ABSTRACT
We report a unique first case of benign heterotopic pancreas arising within the proximal hepatic bile duct, containing a focus of intraductal papillary mucinous neoplasm (IPMN). The condition was diagnosed on pathological explant after left hepatic lobectomy with total extrahepatic bile duct excision.

No MeSH data available.


Related in: MedlinePlus

(a) Magnetic resonance cholangiopancreatography (MRCP) and (b) endoscopic retrograde cholangiopancreatography (ERCP) demonstrating stricture and occlusion of the proximal main hepatic duct (marked with red arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4352448&req=5

fig1: (a) Magnetic resonance cholangiopancreatography (MRCP) and (b) endoscopic retrograde cholangiopancreatography (ERCP) demonstrating stricture and occlusion of the proximal main hepatic duct (marked with red arrow).

Mentions: An obese otherwise healthy 47-year-old female (body mass index 36) presented with intermittent nausea and right upper quadrant discomfort after intentional weight loss of 27 kg. The serum lipase was found to be mildly elevated at 132 units. Abdominal ultrasound demonstrated focal dilatation of the intrahepatic left hepatic ducts, and a subsequent contrast-enhanced magnetic resonance cholangiopancreatogram (MRCP) and endoscopic retrograde cholangiopancreatogram (ERCP) demonstrated an occlusive filling defect within the proximal main biliary tree (Figure 1). An intravenous contrast-enhanced computed tomogram (CT) demonstrated a vascular, arterially enhancing filling defect within the proximal hepatic duct, with associated proximal biliary tree dilatation (Figure 2). A SpyGlass cholangiogram (Boston Scientific, Marlborough MA, USA) then revealed a frond-like polyp within the common hepatic duct, with no evidence of stone disease. Both SpyGlass-directed brushings and a blind biopsy demonstrated benign epithelial cells but were considered nondiagnostic.


Heterotopic Pancreas within the Proximal Hepatic Duct, Containing Intraductal Papillary Mucinous Neoplasm.

Lawrence AJ, Thiessen A, Morse A, Shapiro AM - Case Rep Surg (2015)

(a) Magnetic resonance cholangiopancreatography (MRCP) and (b) endoscopic retrograde cholangiopancreatography (ERCP) demonstrating stricture and occlusion of the proximal main hepatic duct (marked with red arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352448&req=5

fig1: (a) Magnetic resonance cholangiopancreatography (MRCP) and (b) endoscopic retrograde cholangiopancreatography (ERCP) demonstrating stricture and occlusion of the proximal main hepatic duct (marked with red arrow).
Mentions: An obese otherwise healthy 47-year-old female (body mass index 36) presented with intermittent nausea and right upper quadrant discomfort after intentional weight loss of 27 kg. The serum lipase was found to be mildly elevated at 132 units. Abdominal ultrasound demonstrated focal dilatation of the intrahepatic left hepatic ducts, and a subsequent contrast-enhanced magnetic resonance cholangiopancreatogram (MRCP) and endoscopic retrograde cholangiopancreatogram (ERCP) demonstrated an occlusive filling defect within the proximal main biliary tree (Figure 1). An intravenous contrast-enhanced computed tomogram (CT) demonstrated a vascular, arterially enhancing filling defect within the proximal hepatic duct, with associated proximal biliary tree dilatation (Figure 2). A SpyGlass cholangiogram (Boston Scientific, Marlborough MA, USA) then revealed a frond-like polyp within the common hepatic duct, with no evidence of stone disease. Both SpyGlass-directed brushings and a blind biopsy demonstrated benign epithelial cells but were considered nondiagnostic.

Bottom Line: We report a unique first case of benign heterotopic pancreas arising within the proximal hepatic bile duct, containing a focus of intraductal papillary mucinous neoplasm (IPMN).The condition was diagnosed on pathological explant after left hepatic lobectomy with total extrahepatic bile duct excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7.

ABSTRACT
We report a unique first case of benign heterotopic pancreas arising within the proximal hepatic bile duct, containing a focus of intraductal papillary mucinous neoplasm (IPMN). The condition was diagnosed on pathological explant after left hepatic lobectomy with total extrahepatic bile duct excision.

No MeSH data available.


Related in: MedlinePlus