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Archives de Pediatrie : Organe Officiel... Jan 2020Feeding problems and gastrointestinal disorders are the most common anomalies in people with Down syndrome (DS) and have a significant impact on their daily life. This... (Review)
Review
BACKGROUND AND METHOD
Feeding problems and gastrointestinal disorders are the most common anomalies in people with Down syndrome (DS) and have a significant impact on their daily life. This study lists the various anomalies on the basis of 504 references selected from a PubMed search in October 2018.
RESULTS
The anomalies are grouped into three categories: anatomical anomalies: duodenal atresia and stenosis (3.9%), duodenal web and annular pancreas; aberrant right subclavian artery (12% of children with DS with cardiac anomaly); Hirschsprung's disease (2.76%); anorectal malformation (1.16%); congenital vascular malformations of the liver; orofacial cleft, bifid uvula (4.63%), and submucous orofacial cleft; esophageal atresia (0.5-0.9%); pyloric stenosis (0.3%); diaphragmatic hernia; malrotation of small intestine or duodenum inversum; omphalocele, gastroschisis or anomalies of the median line, anomalies of the umbilical vein; biological, immunological, and infectious anomalies: neonatal cholestasis (3.9%); neonatal hepatic fibrosis; Helicobacter pylori infection (75.8% in institutionalized children with DS, between 29.2 and 19.5% in non-institutionalized); non-alcoholic fatty liver disease (NAFLD; 82% in obese and 45% in non-obese); biliary lithiasis (6.9% under 3 years); celiac disease (6.,6%); geographical tongue (4%); hepatitis B virus sensitivity; autoimmune hepatitis and cholangitis; Crohn's disease, inflammatory bowel disease (IBD); pancreatitis; vitamin D deficiency (45.2% in Italy); functional disorders: suction, swallowing and chewing disorders (13 of 19 children with DS under 4 years); gastroesophageal reflux (47% in children with sleep apnea); achalasia (0,5% in adults); obesity (51.6% of males and 40.0% of females in Ireland) and overweight (32.0% and 14.8%); constipation (19.0%). Based on their practice, the authors insist on the following points: malformations are sometimes detected late (chronic vomiting after the introduction of food pieces, resistant constipation despite appropriate measures); prescription of preventive doses of vitamin D is advised; jaundice in a baby with DS may be retentional; in the event of transient leukemoid reaction it is vital to monitor liver function; the patient with geographic tongue must be reassured; for celiac serology there is no consensus on the staring age and the frequency, we propose every year from the age of 2; we advise to test people with DS for H. pylori infection if they are attending specialized institutions; abdominal ultrasounds must be systematic during the first months of life; detection of NAFLD is recommended; people with DS must be vaccinated against hepatitis B; breastfeeding is possible with maternal support; it is important to start speech therapy very early; feeding difficulties are often overlooked by the family and educators; gastroesophageal reflux is often pathological; preventing obesity must start from birth using body mass index for the general population; it is necessary to do everything for their meals to be joyful.
Topics: Adolescent; Child; Child, Preschool; Down Syndrome; Feeding and Eating Disorders of Childhood; Female; Gastrointestinal Diseases; Humans; Infant; Infant, Newborn; Male; Young Adult
PubMed: 31784293
DOI: 10.1016/j.arcped.2019.11.008 -
The British Journal of Surgery Sep 2022
Topics: Humans; Pancreas; Pancreatic Diseases
PubMed: 36084336
DOI: 10.1093/bjs/znac167 -
Clinical Gastroenterology and... Jun 2020
Topics: Humans; Pancreas; Pancreatic Diseases
PubMed: 30710695
DOI: 10.1016/j.cgh.2019.01.036 -
Abdominal Radiology (New York) May 2020Developmental anomalies of the pancreas include more common entities such as pancreas divisum and annular pancreas, and unusual entities such as heterotopic pancreas.... (Review)
Review
Developmental anomalies of the pancreas include more common entities such as pancreas divisum and annular pancreas, and unusual entities such as heterotopic pancreas. While these anomalies can present a diagnostic challenge to the radiologist, when the pancreatic tissue involved in these processes develops pancreatitis, the radiographic appearance can present a diagnostic dilemma. Awareness of these pancreatic anomalies and familiarity with their appearance when inflamed is necessary to distinguish pancreatitis in the developmentally anomalous pancreas from other inflammatory or neoplastic processes.
Topics: Diagnosis, Differential; Humans; Pancreas; Pancreatitis
PubMed: 31468154
DOI: 10.1007/s00261-019-02197-8 -
Diagnostics (Basel, Switzerland) Oct 2023Embryological development of the pancreas is a complex phenomenon and, therefore, it can have multiple developmental aberrations. Fortunately, the majority of these... (Review)
Review
Embryological development of the pancreas is a complex phenomenon and, therefore, it can have multiple developmental aberrations. Fortunately, the majority of these pancreatic ductal anomalies are asymptomatic with no clinical relevance and are incidentally detected during diagnostic cross-sectional imaging or endoscopic retrograde cholangiopancreatography (ERCP) or autopsy. Occasionally, pancreatic duct anomalies can result in symptoms like abdominal pain or recurrent pancreatitis. Also, an accurate pre-operative diagnosis of ductal anomalies can prevent inadvertent duct injury during surgery. Conventionally, ERCP had been used for an accurate diagnosis of pancreatic duct anomalies. However, because it is invasive and associated with a risk of pancreatitis, it has been replaced with magnetic resonance cholangiopancreatography (MRCP). MRCP has demonstrated high sensitivity and specificity for the diagnosis of ductal anomalies, which can be further improved with the use of secretin-enhanced MRCP. Endoscopic ultrasound (EUS) is a new diagnostic and interventional tool in the armamentarium of endoscopists and has demonstrated promising results in the detection of pancreatic duct variations and anomalies. Along with the visualization of the course and configuration of the pancreatic duct, EUS can also visualize changes in the pancreatic parenchyma, thereby helping with an early diagnosis of any co-existent pancreatic disease. Absence of the stack sign and crossed duct sign are important EUS features to diagnose pancreas divisum. EUS can also help with the diagnosis of other congenital ductal anomalies like annular pancreas, ansa pancreatica, and anomalous pancreaticobiliary union, although the published experience is limited.
PubMed: 37835872
DOI: 10.3390/diagnostics13193129 -
Proceedings (Baylor University. Medical... Oct 2016Annular pancreas is a developmental anomaly that can be associated with other conditions such as Down syndrome, duodenal atresia, and Hirschsprung disease. A band of...
Annular pancreas is a developmental anomaly that can be associated with other conditions such as Down syndrome, duodenal atresia, and Hirschsprung disease. A band of pancreatic tissue, in continuity with the pancreatic head, completely or incompletely encircles the descending duodenum, sometimes assuming a "crocodile jaw" configuration. We present the case of an adult who presented with epigastric pain and vomiting and was found to have annular pancreas.
PubMed: 27695176
DOI: 10.1080/08998280.2016.11929487 -
Abdominal Radiology (New York) Feb 2018Pancreatic ductal adenocarcinoma is the most common primary malignancy of the pancreas. The classic imaging features are a hypovascular mass with proximal ductal... (Review)
Review
Pancreatic ductal adenocarcinoma is the most common primary malignancy of the pancreas. The classic imaging features are a hypovascular mass with proximal ductal dilatation. Different pancreatic pathologies can mimic the imaging appearance of carcinoma including other tumors involving the pancreas (pancreatic neuroendocrine tumors, lymphoma, metastasis, and rare tumors like pancreatic acinar cell carcinoma and solid pseudopapillary tumors), inflammatory processes (chronic pancreatitis and autoimmune pancreatitis), and anatomic variants (annular pancreas). Differentiation between these entities can sometimes be challenging due to overlap of imaging features. The purpose of this article is to describe the common entities that can mimic pancreatic cancer on imaging with illustrative examples and to suggest features that can help in differentiation of these entities.
Topics: Anatomic Variation; Autoimmune Diseases; Carcinoma, Pancreatic Ductal; Diagnosis, Differential; Humans; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis
PubMed: 29038855
DOI: 10.1007/s00261-017-1330-1 -
Journal of Applied Clinical Medical... Jan 2022To investigate annular pancreas in adults using imaging features displayed on computed tomography (CT) and magnetic resonance imaging (MRI).
BACKGROUND AND PURPOSE
To investigate annular pancreas in adults using imaging features displayed on computed tomography (CT) and magnetic resonance imaging (MRI).
METHODS
Retrospective review of annular pancreas in patients undergoing CT or MRI examinations. Two abdominal radiologists blindly reviewed the CT, MRI, and magnetic resonance cholangiopancreatography (MRCP) images from the Picture Archiving and Communication Systems (PACS). A Kruskal-Wallis test was performed to evaluate subjective scoring, with Mann-Whitney test for the comparison. A p-value less than 0.05 was considered statistically significant.
RESULTS
Eleven patients (45.8%) presented a complete ring of pancreatic tissue surrounding duodenum, displayed as circular, triangular, or sandwich sign configuration, the other 13 patients (54.2%) had incomplete annular pancreas which displayed a crocodile jaw appearance, pancreatic tissue extending in a posterolateral or anterolateral direction towards duodenum. When comparing CT images of each sequence, the arterial phase group had the highest score compared with the venous phase and the plain film group (χ = 58.21, p < 0.05). When comparing MRI enhancement volumetric interpolated breath-hold examination (VIBE) sequences, arterial phase group scores were the highest (χ = 18.98, p < 0.05).
CONCLUSIONS
Both CT and MRI could detect annular pancreas, with artery phase being the best sequence to diagnose annular pancreas.
Topics: Adult; Humans; Magnetic Resonance Imaging; Pancreas; Pancreatic Diseases; Retrospective Studies; Tomography, Spiral Computed; Tomography, X-Ray Computed
PubMed: 34845829
DOI: 10.1002/acm2.13487 -
Khirurgiia 2018Annular pancreas is a rare condition followed by circumferential involvement of another anatomical structure. In this case, involvement of the pancreas is most frequent... (Review)
Review
Annular pancreas is a rare condition followed by circumferential involvement of another anatomical structure. In this case, involvement of the pancreas is most frequent type of malformation while portal vein is less common variant. Issues of clinical picture, diagnosis and surgical treatment are reviewed in the article.
Topics: Humans; Pancreas; Pancreatic Diseases; Portal Vein; Vascular Diseases
PubMed: 30560859
DOI: 10.17116/hirurgia2018121126