par Cremer, Michel 
;Toussaint, J.;Hermanus, A.
Référence Acta gastro-enterologica Belgica (Ed. multilingue), 39, 11-12, page (522-546)
Publication Publié, 1976
;Toussaint, J.;Hermanus, A.Référence Acta gastro-enterologica Belgica (Ed. multilingue), 39, 11-12, page (522-546)
Publication Publié, 1976
Article révisé par les pairs
| Résumé : | The radiological signs of endoscopic pancreatography enable definition of a new classification of chronic primary pancreatitis according to the different stages of morphological changes. The morphology of main pancreatic duct and ductules is the main criterion. From our series of 2371 ERCP performed in 1934 patients who were thought to have biliary or pancreatic disease, we observed 158 cases of chronic primary pancreatitis where a precise radiological semiology could be described thanks to a perfect pancreatography. Six categories were defined : minimal changes (47 cases), where only alterations of ductules have been observed; minor pancreatitis (type I = 34 cases) : irregularly outlined main pancreatic duct and alterations of ductules; focal pancreatitis (type II = 11 cases) : macrocystic dilatations of one or several ductules, localized in one segment of he gland; diffuse pancreatitis (type III = 29 cases) : one or several stenoses of the main pancreatic duct, without any dilatation above; segmentary pancreatitis of the head (type IV = 18 cases) : where a stenosis of main pancreatic duct with remarkable dilatation above was observed; and pancreatitis with a stop in the head of the pancreas (type V = 19 cases). The frequency of alcoholism, diabetes mellitus and pain is increasing from type I to type V, such as the male prevalence. Some examples of functional studies in pure pancreatic juice in correlation with morphological changes are reported. |
