Association between chronic asymptomatic pancreatic hyperenzymemia and pancreatic ductal anomalies: a magnetic resonance cholangiopancreatography study
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Elucidating the association between pancreatic ductal anomalies and chronic asymptomatic pancreatic hyperenzymemia using magnetic resonance cholangiopancreatography.
We conducted a single-center, retrospective, case–control study. The healthy community group comprised 554 subjects who participated in a paid, whole-body health checkup program. The patient group comprised 14 subjects with idiopathic pancreatic hyperamylasemia or hyperlipasemia. All subjects underwent magnetic resonance cholangiopancreatography. The clinical features and incidence rates of pancreatic ductal anomalies were then compared between the groups.
Compared to the healthy community group, the patient group was significantly more likely to be ≥ age 65 (71.4% of patient group vs. 22.1% of healthy community group), have a history of diabetes mellitus (21.4% vs. 5.4%) or hypertension (35.7% vs. 11.4%), and to have pancreas divisum (21.4% vs. 2.7%), meandering main pancreatic duct (21.4% vs. 4.1%), Wirsungocele (14.3% vs. 1.1%), or dilated main pancreatic duct (14.3% vs. 2.3%). Multivariate analysis found that age ≥ 65 (odds ratio 8.76), presence of pancreas divisum (odds ratio 13.2), meandering main pancreatic duct (odds ratio 8.95), and Wirsungocele (odds ratio 17.6) were independent factors significantly associated with chronic asymptomatic pancreatic hyperenzymemia.
Pancreas divisum, meandering main pancreatic duct, and Wirsungocele were independently associated with chronic asymptomatic pancreatic hyperenzymemia.
KeywordsAmylase Lipase Magnetic resonance imaging Pancreatitis
This work was supported by JSPS KAKENHI Grant Number JP25870148.
Compliance with ethical standards
Conflict of interest
All authors have no conflict of interest to declare.
Our Institutional Review Board approved this STROBE-compliant single-center retrospective case–control study.
Our Institutional Review Board waived informed consent for this STROBE-compliant single-center retrospective case–control study.
We confirm that this study is STROBE-compliant.
- 2.Donati F, Boraschi P, Gigoni R, Salemi S, Faggioni L, Bertucci C, Cecchi C, Bartolozzi C, Falaschi F (2010) Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia. Eur J Radiol 75 (2):e38-44. https://doi.org/10.1016/j.ejrad.2009.11.008 CrossRefGoogle Scholar
- 5.Gonoi W, Akai H, Hagiwara K, Akahane M, Hayashi N, Maeda E, Yoshikawa T, Tada M, Uno K, Ohtsu H, Koike K, Ohtomo K (2011) Pancreas divisum as a predisposing factor for chronic and recurrent idiopathic pancreatitis: initial in vivo survey. Gut 60 (8):1103-1108. https://doi.org/10.1136/gut.2010.230011 CrossRefGoogle Scholar
- 6.Gonoi W, Akai H, Hagiwara K, Akahane M, Hayashi N, Maeda E, Yoshikawa T, Kiryu S, Tada M, Uno K, Ohtsu H, Okura N, Koike K, Ohtomo K (2012) Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis. PLoS One 7 (5):e37652. https://doi.org/10.1371/journal.pone.0037652 CrossRefGoogle Scholar
- 7.Vanella G, Arcidiacono PG, Capurso G (2019) Chronic Asymptomatic Pancreatic Hyperenzymemia (CAPH): Meta-analysis of pancreatic findings at second-level imaging. Pancreatology. https://doi.org/10.1016/j.pan.2019.01.022
- 8.Lott JA, Lu CJ (1991) Lipase isoforms and amylase isoenzymes: assays and application in the diagnosis of acute pancreatitis. Clin Chem 37 (3):361-368Google Scholar
- 9.Frulloni L, Patrizi F, Bernardoni L, Cavallini G (2005) Pancreatic hyperenzymemia: clinical significance and diagnostic approach. JOP 6 (6):536-551Google Scholar
- 11.Gonoi W, Akai H, Hagiwara K, Akahane M, Hayashi N, Maeda E, Yoshikawa T, Kiryu S, Tada M, Uno K, Okura N, Koike K, Ohtomo K (2013) Santorinicele without pancreas divisum pathophysiology: initial clinical and radiographic investigations. BMC Gastroenterol 13:62. https://doi.org/10.1186/1471-230X-13-62 CrossRefGoogle Scholar
- 18.Bertin C, Pelletier AL, Vullierme MP, Bienvenu T, Rebours V, Hentic O, Maire F, Hammel P, Vilgrain V, Ruszniewski P, Levy P (2012) Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol 107 (2):311-317. https://doi.org/10.1038/ajg.2011.424 CrossRefGoogle Scholar
- 19.Tabary O, Zahm JM, Hinnrasky J, Couetil JP, Cornillet P, Guenounou M, Gaillard D, Puchelle E, Jacquot J (1998) Selective up-regulation of chemokine IL-8 expression in cystic fibrosis bronchial gland cells in vivo and in vitro. Am J Pathol 153 (3):921-930. https://doi.org/10.1016/S0002-9440(10)65633-7 CrossRefGoogle Scholar
- 23.Coelho DE, Ardengh JC, Lima-Filho ER, Coelho JF (2011) Different clinical aspects of Wirsungocele: case series of three patients and review of literature. Acta Gastroenterol Latinoam 41 (3):230-233Google Scholar
- 26.Antonini F, Belfiori V, Pagano N, Buscarini E, De Minicis S, Lo Cascio M, Marraccini B, Piergallini S, Rossetti P, Andrenacci E, Macarri G, Pezzilli R (2017) Endoscopic ultrasonography may select subjects having asymptomatic chronic pancreatic hyperenzymemia who require a stricter follow-up. Pancreas 46 (4):524–527. https://doi.org/10.1097/MPA.0000000000000796 CrossRefGoogle Scholar