| Theme |
Recent Issues of Pancreaticobiliary Maljunction |
| Title |
Diagnosis of Pancreaticobiliary Maijunction in Adults |
| Author |
Fumitake Toki |
Department of Radiology, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Takayoshi Nishino |
Department of Medicine, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Hiroyasu Oyama |
Department of Clinical Chemistry, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Itaru Oi |
Department of Endoscopy, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Naoaki Hayashi |
Department of Medicine, Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Ken Takasaki |
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] |
Pancreaticobiliary maljunction (PBM) is associated with a high incidence of biliary carcinoma (10-35%), and early diagnosis is therefore very important. PBM does not have characteristic symptoms, often appearing as abdominal pain, nausea/vomiting, etc. Diagnosis is confirmed by direct pancreatocholangiography (principally ERCP), when bile duct dilatation is detected by US (congenital cholangiectasis is a common complication). Recently, it has become possible to also diagnose this condition with endoscopic ultrasonography (EUS) and non-invasive MRCP. An important point related to US is that thickening, caused by hypertrophy of the gallbladder wall, is often seen in PBM. In PBM, the so-called common channel (the extramural common portion) is sometimes dilated and a protein plug or a non-calcified calculus can be seen, causing acute pancreatitis. Detailed visualization of PBM is therefore essential, and ERCP is useful in diagnosing PBM. |