AIMS: The main objective of this study was to determine the sensitivity of abdominal ultrasonography (US) in patients with isoattenuating pancreatic carcinoma and to compare the frequency of secondary signs on abdominal US and endoscopic ultrasonography (EUS) in these tumours. METHODS: Twenty-four patients with histologically or cytologically verified isoattenuating pancreatic carcinoma who underwent abdominal US, contrast-enhanced CT and EUS of the pancreas as part of the diagnostic workup were included in this retrospective study. The sensitivity of abdominal US in detecting the isoattenuating pancreatic carcinoma was investigated and the frequency of secondary signs of isoattenuating pancreatic carcinoma on abdominal US and EUS was compared. RESULTS: In 5 of 24 patients (21%) with isoattenuating pancreatic carcinoma, a hypoechogenic pancreatic lesion was directly visualised on abdominal US. Secondary signs were present on US in 21 patients (88%). These included dilatation of the common bile duct and/or intrahepatic bile ducts in 19/24 (79%), dilatation of the pancreatic duct in 3/24 (13%), abnormal contour/inhomogeneity of the pancreas in 1/24 (4%), and atrophy of the distal parenchyma in 1/24 (4%). Pancreatic duct dilatation was observed more frequently on EUS than on abdominal US (P=0.002). For other secondary signs, there was no significant difference in their detection on abdominal US and EUS (P=0.61-1.00). CONCLUSION: Abdominal US is capable of detecting secondary signs of isoattenuating pancreatic carcinoma with high sensitivity and has the potential to directly visualise these tumours.

• Klíčová slova
• computed tomography, endoscopic ultrasonography, isoattenuating, pancreatic cancer, ultrasonography, ultrasound,
• MeSH
• lidé MeSH
• nádory slinivky břišní * diagnostické zobrazování   patologie   MeSH
• počítačová rentgenová tomografie * MeSH
• retrospektivní studie MeSH
• ultrasonografie MeSH
• vývody pankreatu diagnostické zobrazování   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Pancreaticobiliary malunion (PBM) is a distinct disease entity of the pancreatic and biliary ductal system defined as a condition in which the junction of the pancreatic and biliary ducts occurs above the duodenal wall. PBM may be combined with a stenosis of the distal common bile duct and pathological changes in the common bile duct wall (congenital cyst of bile duct), being a potentially malignant condition. Pancreas divisum, resulting from a fusion failure of the ventral and dorsal pancreatic buds, and characterized by a dominant Santorine duct, is considered to be a predisposing factor to recurrent attacks of acute pancreatitis. In incomplete pancreas divisum, the ventral and dorsal pancreas are connected by a segmental branch. MATERIAL AND METHODS: We report a case of a 33-year-old female patient with PBM associated with incomplete pancreas divisum, who had presented episodes of acute cholangitis due to a benign distal common bile duct stricture. RESULTS: Treatment with choledochoduodenostomy and cholecystectomy provided thorough relief and resolution of symptoms. CONCLUSION: This is the first report of coexistent PBM and incomplete pancreas divisum in a Caucasian patient with unusually late clinical manifestation.

• MeSH
• cholangiopankreatografie endoskopická retrográdní * MeSH
• cholestáza diagnostické zobrazování   patologie   chirurgie   MeSH
• dospělí MeSH
• ductus choledochus abnormality   diagnostické zobrazování   MeSH
• lidé MeSH
• vývody pankreatu abnormality   diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

• MeSH
• cholecystektomie MeSH
• dospělí MeSH
• kontrastní látky MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci slinivky břišní diagnostické zobrazování   MeSH
• nemoci žlučového ústrojí diagnostické zobrazování   MeSH
• radiografie MeSH
• vývody pankreatu diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kontrastní látky MeSH

• MeSH
• cholangiografie MeSH
• kontrastní látky škodlivé účinky   MeSH
• lidé MeSH
• psi MeSH
• vývody pankreatu diagnostické zobrazování   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• psi MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kontrastní látky MeSH