Zusammenfassung
Angeborene Pankreaszysten kommen sehr selten vor. Sie treten in der Regel solitär oder in Assoziation mit Nieren- oder Leberzysten sowie anderen angeborenen Erkrankungen auf. Das Pancreas divisum ist die häufigste kongenitale anatomische Anomalie des Pankreas. Es entsteht als sporadische Entwicklungsvariante des Pankreas aufgrund einer unvollständigen Fusion der ventralen mit der dorsalen Pankreasanlage. Als Folge dessen sind der Ductus Wirsungianus und der Ductus Santorini nicht (komplettes Pancreas divisum) oder nur unvollständig (inkomplettes Pancreas divisum) miteinander verbunden, sodass der Großteil des exokrinen Pankreassekrets durch die Minorpapille drainiert wird. Das Pancreas anulare ist eine seltene Entwicklungsstörung des Pankreas, bei der die Rotation der ventralen Pankreasanlage um das Duodenum unvollständig ist. Folge dessen ist ein ringförmig die Pars descendens duodeni umschließendes Pankreas. Das Pancreas bifidum ist eine sehr seltene Fusionsanomalie des Pankreas, bei der das Pankreas im Schwanzbereich einen zweigeteilten Hauptgang aufweist. Die seltene Pankreasektopie beschreibt das Vorhandensein von Pankreasgewebe an einer abnormalen Lokalisation.
Literatur
Agha FP, Williams KD (1987) Pancreas divisum: incidence, detection, and clinical significance. Am J Gastroenterol 82:315–320
Akisik MF, Sandrasegaran K, Aisen AA et al (2006) Dynamic secretin-enhanced MR Cholangiopancreatography. Radiographics 26:665–677
Armstrong CP, King PM, Dixon JM et al (1981) The clinical significance of heterotopic pancreas in the gastrointestinal tract. Br J Surg 68:384–387
Attwell A, Borak G, Hawes R et al (2006) Endoscopic pancreatic sphincterotomy for pancreas divisum by using a needle-knife or standard pull-type technique: safety and reintervention rates. Gastrointest Endosc 64:705–711
Baggott BB, Long WB (1991) Annular pancreas as a cause of extrahepatic biliary obstruction. Am J Gastroenterol 86:224–226
Bailey PV, Tracy TF Jr, Connors RH et al (1993) Congenital duodenal obstruction: a 32-year review. J Pediatr Surg 28:92–95
Baldwin WA (1910) A specimen of annular pancreas. Anat Rec 4:299–304
Benage D, McHenry R, Hawes RH et al (1990) Minor papilla cannulation and dorsal ductography in pancreas divisum. Gastrointest Endosc 36:553–557
Bernard JP, Sahel J, Giovannini M et al (1990) Pancreas divisum is a probable cause of acute pancreatitis: a report of 137 cases. Pancreas 5:248–254
Bertin C, Pelletier AL, Vullierme MP et al (2012) Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol 107:311–317
Bret PM, Reinhold C, Taourel P et al (1996) Pancreas divisum: evaluation with MR cholangiopancreatography. Radiology 199:99–103
Brönnimann E, Potthast S, Vlajnic T (2010) Annular pancreas associated with duodenal carcinoma. World J Gastroenterol 16:3206–3210
Bülow R, Simon P, Thiel R, Thamm P, Messner P, Lerch MM, Mayerle J, Völzke H, Hosten N, Kühn JP (2014) Anatomic variants of the pancreatic duct and their clinical relevance: an MR-guided study in the general population. Eur Radiol 24(12):3142–3149
Burtin P, Person B, Charneau J et al (1991) Pancreas divisum and pancreatitis: a coincidental association? Endoscopy 23:55–58
Cahen DL, Gouma DJ, Nio Y et al (2007) Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med 356:676–684
Cho JS, Skin KS, Kwon ST et al (2000) Heterotopic pancreas in the stomach: CT findings. Radiology 217:139–144
Choi JY, Kim MJ, Kim JH et al (2004) Annular pancreas: emphasis on magnetic resonance cholangiopancreatography findings. J Comput Assist Tomogr 28:528–532
Cotton PB, Eisen G, Romagnuolo G et al (2011) Grading the complexity of endoscopic procedures: results of an ASGE working party. Gastrointest Endosc 73:868–874
Dhar A, Goenka MK, Kochhar R et al (1996) Pancreas divisum: five years’ experience in a teaching hospital. Indian J Gastroenterol 15:7–9
Dinter D, Löhr JM, Neff KW (2007) Bifid tail of the pancreas: benign bifurcation anomaly. AJR 189:W251–W253
Dowsett JF, Rode J, Russell RC (1989) Annular pancreas: a clinical, endoscopic and immunohistochemical study. Gut 30:130–135
Dumonceau JM, Andriulli A, Elmunzer BJ et al (2014) Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) guideline – updated June 2014. Endoscopy 46:799–815
Ecker A (1862) Bildungsfehler des Pankreas und des Herzens. Z Rat Med 14:354
Eisenberger CF, Gocht A, Knoefel WT et al (2004) Heterotopic pancreas – clinical presentation and pathology with review of the literature. Hepatogastroenterology 51:854–858
Ertan A (2000) Long-term results after endoscopic pancreatic stent placement without pancreatic papillotomy in acute recurrent pancreatitis due to pancreas divisum. Gastrointest Endosc 52:9–14
Escobar MA, Ladd AP, Grosfeld JL et al (2004) Duodenal atresia and stenosis: long-term follow-up over 30 years. J Pediatr Surg 39:867–871, discussion 867-871
Etienne D, John A, Menias CO et al (2012) Annular pancreas: a review of its molecular embryology, genetic basis and clinical considerations. Ann Anat 194:422–428
Fatima H, Malcolm M, Sherman S et al (2007) Pancreas divisum: a retrospective review to evaluate the risk of biliary tract neoplasms. Pract Gastroenterol 31:24–34
Flora KD, Katon RM (1993) Benign bifurcation of the pancreatic duct presenting as a pancreatic mass on CT scan. Am J Gastroenterol 88:2121–2122
Garn T, Hallenscheidt T, Schumacher B et al (2011) Tumor of the esophoagocardiac junction. Chirurg 82:447–449
Gilinsky NH, Lewis JW, Flueck JA et al (1987) Annular pancreas associated with diffuse chronic pancreatitis. Am J Gastroenterol 82:681–684
Hebrok M, Kim SK, St Jacques B et al (2000) Regulation of pancreas development by hedgehog signaling. Development 127:4905–4913
Hellerhoff KJ, Helmberger H 3rd, Rosch T et al (2002) Dynamic MR pancreatography after secretin administration: image quality and diagnostic accuracy. AJR Am J Roentgenol 179:121–129
Heyries L, Barthet M, Delvasto C et al (2002) Long-term results of endoscopic management of pancreas divisum with recurrent acute pancreatitis. Gastrointest Endosc 55:376–381
Hoffmeister A, Mayerle J, Beglinger C et al (2012) S3-Leitlinie Chronische Pankreatitis: Definition, Ätiologie, Diagnostik, konservative, interventionell endoskopische und operative Therapie der chronischen Pankreatitis. Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). Z Gastroenterol 50:1176–1224
Hsia CY, Wu CW, Lui WY (1999) Heterotopic pancreas: a difficult diagnosis. J Clin Gastroenterol 28:144–147
Jarikji Z, Horb LD, Shariff F et al (2009) The tetraspanin Tm4sf3 is localized to the ventral pancreas and regulates fusion of the dorsal and ventral pancreatic buds. Development 136:1791–1800
Jowell PS, Branch MS, Fein SH et al (2011) Intravenous synthetic secretin reduces the incidence of pancreatitis induced by endoscopic retrograde cholangiopancreatography. Pancreas 40:533–539
Kamisawa T, Yuyang T, Egawa N et al (2001) A new embryologic hypothesis of annular pancreas. Hepatogastroenterology 48:277–278
Kamisawa T, Yoshiike M, Egawa N et al (2005) Pancreatic tumor associated with pancreas divisum. J Gastroenterol Hepatol 20:915–918
Kimura W, Nagai H, Kuroda A et al (1995) Analysis of small cystic lesions of the pancreas. Int J Pancreatol 18:197–206
Kozarek RA (1990) Pancreatic stents can induce ductal changes consistent with chronic pancreatitis. Gastrointest Endosc 36:93–95
Ladd AP, Madura JA (2001) Congenital duodenal anomalies in the adult. Arch Surg 136:576–584
Lans JI, Geenen JE, Johanson JF et al (1992) Endoscopic therapy in patients with pancreas divisum and acute pancreatitis: a prospective, randomized, controlled clinical trial. Gastrointest Endosc 38:430–434
Lecco TM (1910) Zur Morphologie des Pankreas anulare. Sitzungb Akad Wissensch 119:391–406
Lee NK, Kim S, Jeon TY et al (2010) Complications of congenital and developmental abnormalities of the gastrointestinal tract in adolescents and adults: evaluation with multimodality imaging. Radiographics 30:1489–1507
Lehman GA, Sherman S (1998) Diagnosis and therapy of pancreas divisum. Gastrointest Endosc Clin N Am 8:55–77
Lerch MM, Zenker M, Turi S, Mayerle J (2006) Developmental and metabolic disorders of the pancreas. Endocrinol Metab Clin North Am 35(2):219–241
Liao Z, Li ZS, Wang W et al (2009) Endoscopic placement of a covered self-expandable metal stent in the minor papilla in patients with chronic pancreatitis and pancreas divisum. Endoscopy 41(Suppl 2):E302–E303
Low G, Panu A, Millo N et al (2011) Multimodality imaging of neoplastic and nonneoplastic solid lesions of the pancreas. Radiographics 31:993–1015
Lucena JF, Alvarez OA, Gross GW (1997) Endoscopic resection of heterotopic pancreas of the minor duodenal papilla: case report and review of the literature. Gastrointest Endosc 46:69–72
Manfredi R, Costamagna G, Brizi MG et al (2000) Pancreas divisum and „santorinicele“: diagnosis with dynamic MR cholangiopancreatography with secretin stimulation. Radiology 217:403–408
Matos C, Metens T, Devière J et al (2001) Pancreas divisum: evaluation with secretin-enhanced magnetic resonance cholangiopancreatography. Gastrointest Endosc 53:728–733
Moffatt DC, Coté GA, Avula H et al (2011) Risk factors for ERCP-related complications in patients with pancreas divisum: a retrospective study. Gastrointest Endosc 73:963–970
Mortelé KJ, Rocha TC, Streeter JL et al (2006) Multimodality imaging of pancreatic and biliary congenital anomalies. RadioGraphics 26:715–731
Mosler P, Akisik F, Sandrasegaran K et al (2012) Accuracy of magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum. Dig Dis Sci 57:170–174
Neuhaus H (2004) Therapeutic pancreatic endoscopy. Endoscopy 36:8–16
Nishino T, Toki F, Oi I et al (2006) Prevalence of pancreatic and biliary tract tumors in pancreas divisum. J Gastroenterol 41:1088–1093
Norton ID, Petersen BT (1999) Interventional treatment of acute and chronic pancreatitis. Endoscopic procedures. Surg Clin North Am 79:895–911
Nugent C, Ruffolo T, Hawes R et al (1993) Is pancreas divisum associated with biliary tract carcinoma? Gastrointest Endosc 39:327
Ravitch MM, Woods AC Jr (1950) Annular pancreas. Ann Surg 132:1116–1127
Riemann JF, Fischbach W, Galle PR et al (2008) Gastroenterologie, band 2: leber, galle pankreas. Thieme Verlag, Stuttgart, S 1779
Sandrasegaran K, Patel A, Fogel EL et al (2009) Annular pancreas in adults. Am J Roentgenol 193:455–460
Sencan A, Mir E, Günsar C et al (2002) Symptomatic annular pancreas in newborns. Med Sci Monit 8:CR434–CR437
Shan YS, Sy ED, Lin PW (2002) Annular pancreas with obstructive jaundice: beware of underlying neoplasm. Pancreas 25:314–316
Shanbhogue AK, Fasih N, Surabhi VR et al (2009) A clinical and radiologic review of uncommon types and causes of pancreatitis. Radiographics 29:1003–1026
Silva AC, Charles JC, Kimery BD et al (2006) MR Cholangiopancreatography in the detection of symptomatic ectopic pancreatitis in the small-bowel mesentery. Am J Roentgenol 187:W195–W197
Silverman JF, Prichard J, Regueiro MD (2001) Fine needle aspiration cytology of a pancreatic cyst in a patient with autosomal dominant polycystic kidney disease. A case report. Acta Cytol 45:415–419
Smith MT, Sherman S, Ikenberry SO et al (1996) Alterations in pancreatic ductal morphology following polyethylene pancreatic stent therapy. Gastrointest Endosc 44:268–275
Song JY, Han JY, Choi SK et al (2012) Adenocarcinoma with intraductal papillary mucinous neoplasm arising in jejunal heterotopic pancreas. Korean J Pathol 46:96–100
Spicak J, Poulova P, Plucnarova J et al (2007) Pancreas divisum does not modify the natural course of chronic pancreatitis. J Gastroenterol 42:135–139
Stimec B, Bulajic M, Tatic S et al (1996) Unusual variants of the tributaries of the main pancreatic duct revealed by postmortem and endoscopic pancreatography. Ann Anat 178:169–171
Takuma K, Kamisawa T, Tabata T et al (2010) Pancreatic diseases associated with pancreas divisum. Dig Surg 27:144–148
Tiedemann F (1818) Über die Verschiedenheiten des Ausführungsganges der Bauchspeicheldruse bei den Menschen und Säugetieren. Dtsch Arch Physiol 4:403
Torfs CP, Christianson RE (1998) Anomalies in down syndrome individuals in a large population-based registry. Am J Med Genet 77:431–438
Traverso LW, Kozarek RA, Simpson T et al (1993) Pancreatic duct obstruction as a potential etiology of pancreatic adenocarcinoma: a clue from pancreas divisum. Am J Gastroenterol 88:117–119
Trifan A, Târcoveanu E, Danciu M et al (2012) Gastric heterotopic pancreas: an unusual case and review of the literature. J Gastrointestin Liver Dis 21:209–212
Uomo G, Manes G, D’Anna L et al (1995) Fusion and duplication variants of pancreatic duct system: clinical and pancreatographic evaluation. Int J Pancreatol 17:23–28
Urayama S, Kozarek R, Ball T et al (1995) Presentation and treatment of annular pancreas in an adult population. Am J Gastroenterol 90:995–999
Varadarajulu S, Wilcox CM (2006) Randomized trial comparing needle-knife and pull-sphincterotome techniques for pancreatic sphincterotomy in high-risk patients. Gastrointest Endosc 64:716–722
Warshaw AL, Richter JM, Schapiro RH (1983) The cause and treatment of pancreatitis associated with pancreas divisum. Ann Surg 198:443–452
Warshaw AL, Simeone JF, Schapiro RH et al (1990) Evaluation and treatment of the dominant dorsal duct syndrome (pancreas divisum redefined). Am J Surg 159:59–64
Watanabe M, Shiozawa K, Kishimoto Y et al (2012) Heterotopic pancreas of the jejunum incidentally detected by preoperative abdominal CT: report of two cases and review of the literature. Case Rep Gastroenterol 6:576–582
Yogi Y, Shibue T, Hashimoto S (1987) Annular pancreas detected in adults, diagnosed by endoscopic retrograde cholangiopancreatography: report of four cases. Gastroenterol Jpn 22:92–99
Yogi Y, Kosai S, Higashi S et al (1999) Annular pancreas associated with pancreatolithiasis: a case report. Hepatogastroenterology 46:527–531
Yuan Z, Chen J, Zheng Q et al (2009) Heterotopic pancreas in the gastrointestinal tract. World J Gastroenterol 15:3701–3703
Zyromski NJ, Sandoval JA, Pitt HA et al (2008) Annular pancreas: dramatic differences between children and adults. J Am Coll Surg 206:1019–1025, discussion 1025–1027
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Kandler, J., Neuhaus, H. (2015). Angeborene Anomalien des Pankreas. In: Lehnert, H., et al. SpringerReference Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_68-1
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