Juxtapancreatic intestinal duplications with pancreatic ductal communication: a cause of XXXX and recurrent @entity490 in childhood.

@entity1 @entity32 @entity788 @entity82 @entity390 @entity353 @entity391 @entity9007 @entity158 @entity490 @entity356
Pancreatic duplications with ductal communications should be included in the differential diagnosis of any @entity1 presenting with recurrent @entity490 of unknown etiology and should be considered as a possible cause of @entity788 in childhood. Such duplications most likely arise from nonregressing diverticula of the pancreatic bud during embryologic development. Their clinical presentation is unique from other duplications because of their anatomic association with the pancreatic duct. @entity158 and @entity353 are the major presenting complaints, although many @entity1 have @entity390 and @entity391 . Serum chemistries, in particular the serum amylase, are usually normal and are of little help in the differential diagnosis. Radiographic evaluation has not been particularly helpful in the past. ERCP, ultrasonic examination, and CT scan show great promise, however. Operative intervention should be tailored for the individual @entity1 . The operation performed will depend upon operative findings. Intraoperative pancreatograms or cystograms are very helpful in differentiating these cysts from others at the time of operation. Pathologically, most of the duplications have a thickened muscular coat that usually has some evidence of @entity32 . They are usually lined with @entity356 . Except in the most severe cases, the pancreas is histologically normal, suggesting that most of the @entity158 experienced by these @entity1 is secondary to @entity32 within the duplication. The inflammatory response may completely destroy the mucosal lining and cause @entity82 within the muscular coat of the duplication. In those instances, these lesions cannot be differentiated from @entity9007 . This may account for some of the "idiopathic @entity9007 reported in the literature.
