ABSTRACT
Pancreas divisum is a common congenital abnormality of the pancreas that results from the lack of fusion between the dorsal and ventral pancreatic ducts during foetal development. In these cases, the dorsal duct becomes the main pancreatic duct and drains most of the pancreas. Pancreas divisum is mainly asymptomatic, but the prevalence of pancreas divisum is higher in patients with chronic abdominal pain and idiopathic pancreatitis. A study of 20 patients with pancreas divisum (12 men and eight women; aged 19-77 years; mean age 39 years) and who underwent magnetic resonance cholangiopancreatography (MRCP), was performed. In our series, pancreas divisum was clinically manifested as unexplained episodes of abdominal pain (mean duration 3.2 years) (60 percent), mild pancreatitis (30 percent) or incidentally (ten percent). MRCP demonstrated non-communicating dorsal and ventral ducts, independent drainage sites, a dominant dorsal pancreatic duct, and a small cystic dilatation of the dorsal duct at minor papilla (santorinocoele). In this pictorial essay, we review the most common MRCP features of pancreas divisum.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/methods , Magnetic Resonance Imaging/methods , Pancreas/abnormalities , Pancreatic Diseases/pathology , Pancreatitis/pathology , Abdominal Pain , Adult , Aged , Female , Humans , Male , Middle Aged , Pancreatic Diseases/congenital , Pancreatic Diseases/diagnosis , Pancreatitis/diagnosis , Pancreatitis/etiologySubject(s)
MELAS Syndrome/complications , Stroke/etiology , Adult , Brain/pathology , Humans , MELAS Syndrome/pathology , Magnetic Resonance Imaging , Male , Stroke/pathologyABSTRACT
In the early 1990's, a group of physician-epidemiologists developed ways of efficiently tracking down and appraising literature and wrote them up in order to help other doctors, with no or with minimal formal epidemiological training. Today Evidence-Based Medicine (EBM) integrates clinical experience and patient values with the best available research information in order to expand research evidence and to provide sensible answers to medical questions in clinical decision making. Although EBM does not provide the answer to every clinical question, it provides us valuable additional evidence helpful in decision making. EBM process includes five steps: answerable questions asking; accessing for the best information; information appraisal for validity and relevance; data application to patient care and finally evaluation of the performance. The purpose of this paper is to help radiologists who have no postgraduate specialist training in research to become familiar with EBM and to find solutions that are based on best current evidence for problems arising in their practice.
