Pankreas divisum und Pankreatitis

Pancreas divisum and pancreatitis

Zusammenfassung

Klinisches/methodisches Problem

Diagnostik und klinische Relevanz eines Pankreas divisum.

Radiologische Standardverfahren

Ultraschall (US), Magnetresonanz-Cholangiopankreatikographie (MRCP), Magnetresonanztomographie (MRT), Computertomographie (CT), endoskopische retrograde Cholangiopankreatikographie (ERCP)

Leistungsfähigkeit

Das Pankreas divisum ist eine Anlagevariante, die bei ca. 10 % der Bevölkerung auftritt, davon werden ca. 5 % symptomatisch. In der Diagnostik ist die MRT mit MRCP inzwischen die Methode der Wahl.

Bewertung

Die MRT mit MRCP ist in der Diagnostik des Pankreas divisum mit der ERCP gleichwertig, hat dabei aber den Vorteil, dass diese Modalität nicht invasiv ist, gleichzeitig eine Umfelddiagnostik ermöglicht und es nahezu keine Kontraindikationen gibt.

Empfehlung für die Praxis

Es ist wichtig, die Anatomie des pankreatischen Gangsystems zu kennen und zu beachten, damit bei symptomatischen Patienten mögliche Interventionen rechtzeitig geplant werden können.

Abstract

Clinical/methodological issue

Diagnostic and clinical relevance of pancreas divisum.

Standard radiological methods

Ultrasonography (US), magnetic resonance cholangiopancreatography (MRCP), magnetic resonance imaging (MRI), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP).

Performance

Pancreas divisum is an anatomic variation of pancreatic duct system with an incidence in general population of about 10%. It can become symptomatic in approximately 5% of patients. MRI with MRCP is the method of choice to diagnose pancreas divisum.

Achievements

MRCP is equal to ERCP in diagnosing pancreas divisum in routine clinical practice as it is noninvasive, offers the possibility to evaluate the adjacent tissues and has almost no contraindications.

Practical recommendations

It is important to be familiar with the anatomy of the pancreatic duct system in order to plan interventional procedures for symptomatic patients in due time.

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Correspondence to Prof. Dr. med. M. Klauß.

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Interessenkonflikt

E. Khristenko, C. Tjaden und M. Klauß geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Khristenko, E., Tjaden, C. & Klauß, M. Pankreas divisum und Pankreatitis. Radiologe (2021). https://doi.org/10.1007/s00117-021-00848-w

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Schlüsselwörter

  • Pankreasgang
  • Pankreasganganlagevariante
  • Magnetresonanztomographie
  • Magnetresonanz-Cholangiopankreatikographie
  • Sekretin

Keywords

  • Pancreatic duct
  • Anatomic pancreatic duct variation
  • Magnetic resonance imaging
  • Magnetic resonance cholangiopancreatography
  • Secretin