Pankreas Anomalileri
Özet
Pankreasın embriyolojik gelişimi ve konjenital anomalilerini ele alan bu metin, organın dördüncü gebelik haftasında ventral ve dorsal tomurcuklardan nasıl oluştuğunu detaylandırarak başlar. Normal gelişimde bu iki tomurcuk yedinci haftada birleşirken, bu süreçteki hatalar çeşitli klinik anomalilere yol açar. Koledok kistleri, özellikle Tip I ve IV-A, safra yollarının genişlemesiyle karakterizedir ve sıklıkla anormal pankreatikobiliyer bileşke (APBB) ile birliktelik gösterir. APBB, kanalların duodenum dışında birleşmesiyle oluşan ve safra yolu kanseri riskini artıran bir durumdur. Diğer önemli anomaliler arasında, pankreas dokusunun duodenumu çevrelediği halkasal (annüler) pankreas ve kanal sistemlerinin birleşemediği en yaygın anomali olan pankreas divisum yer alır. Metin ayrıca, akut ve kronik pankreatit mekanizmalarını, asiner hücre hasarını ve pankreas yıldız hücrelerinin fibrozis üzerindeki rolünü açıklamaktadır. Sonuç olarak, insanlardaki bu gelişimsel bozuklukların anlaşılmasında memeli ve diğer omurgalı modellerinin önemi vurgulanmaktadır.
This text, focusing on the embryonic development and congenital anomalies of the pancreas, explains how the organ originates from ventral and dorsal buds during the fourth week of gestation. In normal development, these buds fuse by the seventh week; however, disruptions in this process lead to various clinical anomalies. Choledochal cysts, particularly Types I and IV-A, are characterized by biliary dilation and are frequently associated with anomalous pancreaticobiliary junction (APBJ). APBJ is a condition where the ducts unite outside the duodenal wall, increasing the risk of biliary tract cancer. Other significant anomalies include annular pancreas, where pancreatic tissue encircles the duodenum, and pancreas divisum, the most common anomaly resulting from the failure of the duct systems to fuse. The text also details the mechanisms of acute and chronic pancreatitis, emphasizing acinar cell damage and the role of pancreatic stellate cells in fibrosis. Ultimately, the importance of mammalian and other vertebrate models is highlighted for understanding these developmental disorders in humans.
Referanslar
Lewis FT. The bi-lobed form of the ventral pancreas in mammals. American Journal of Anatomy. 1911; 12(3); 389–400.
Odgers PN. Some observations on the development of the ventral pancreas in man. Journal of Anatomy. 1930; 65(1): 1–7
Zimmermann. Rekonstruktionen eines menschlichen embryos von 7 mm. Verhandlungen der Anatomischen Gesellschaft. 1889; 4:139–142.
Felix W. Zur leber- und pankreasentwicklung. Archiv für Anatomie und Entwicklungslehre. 1892: 281–323.
Tadokoro H, Suyama M, Kubokawa Y, Sai J.K. Persistence of the left part of the ventral pancreas may cause congenital biliary dilatation. Pancreas, 2003; 27(1): 47– 51.
Lammert E, Cleaver O, Melton D. Induction of pancre- atic differentiation by signals from blood vessels. Science. 2001; 294(5542): 564–567.
Kelly OG, Melton DA, Development of the pancreas in Xenopus laevis. Developmental Dynamics. 2000; 218(4): 615–627.
Kim SK, Hebrok M, Melton DA. Pancreas develop- ment in the chick embryo. Cold Spring Harbor Symposia on Quantitative Biology.1997; 62:377–383.
Slack JM, Developmental biology of the pancreas. Development. 1995; 121(6): 1569–1580.
The Japanese Study Group on Pancreaticobiliary Maljunction. Diagnostic criteria of pancreaticobiliary maljunction. Journal of Hepato-Biliary-Pancreatic Surgery. 1994; 1(3): 219– 221.
Tadokoro H, Takase M, Nobukawa B, Unusual fusion between ventral and dorsal primordia causes anomalous pancreaticobiliary junction. Pathology International. 2008; 58(8): 498–502.
Kiernan PD, ReMine SG, Kiernan PC, ReMine WH, Annular pancreas: may clinic experience from 1957 to 1976 with review of the literature. 1980; 115(1): 46–50.
Mortele´KJ, Rocha TC, Streeter J.L et al. Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics. 2006; (3): 715–731.
Rizzo RJ, Szucs RA, Turner MA. Congenital abnormalities of the pancreas and biliary tree in adults. Radiographics. 1995; 15(1);49–68.
Bani-Hani KE. Agenesis of the gallbladder: difficulties in management. Journal of Gastroenterology and Hepatology. 2005; 20(5):671–675.
Stoss A. Zur Entwickelungsgeschichte des Pankreas. Anatomischer Anzeiger. 1891; 666–669.
Choronshitzky B. Die Entstehung der Milz, Leber, Gallenblase, Bauchspeicheldrüse und des Pfortadersystems bei den verschiedenen Abteilungen der Wirbeltiere. Anatomische Hefte. I. Abteilung. 1900; 39:33-40.
Helly K. Zur pankreasentwickelung der saugethiere. Archiv für Mikroskopische Anatomie. 1901; 57(2): 271–335.
Malaisse-Lagae F, Stefan Y, Cox J et al. Identification of a lobe in the adult human pancreas rich in pancreatic polypeptide. Diabetologia. 1979; 17(6): 361–365.
Skandalakis JE, Gray SW, Ricketts R et al. The extrahepatic biliary ducts and the gallbladder, London, UK, 1972.
Kimura K, Ohto M, Saisho H et al. Association of gall- bladder carcinoma and anomalous pancreaticobiliary ductal union. Gastroenterology. 1985; 89(6): 1258–1265.
Misra SP, Gulati P, Thorat VK. et al. Pancreaticobiliary ductal union in biliary diseases. An endoscopic retrograde cholangiopancreatographic study. Gastroenterology, 1989; 96(3); 907–912.
Sugiyama M, Baba M, Atomi Y et al. Diagnosis of anomalous pancreaticobiliary junction: value of magnetic resonance cholangiopancreatog- raphy. Surgery. 1998; 123(4):391–397.
Nomura T, Shirai Y, Sandoh N, et al. Cholangiographic criteria for anomalous union of the pancreatic and biliary ducts. Gastrointestinal Endoscopy, 2002; 55(2):204–208.
Uchida T, Takada T, Ammori BJ et al. Three-dimensional reconstruction of the ventral and dorsal pancreas: a new insight into anatomy and embryonic development. Journal of Hepato-Biliary-Pancreatic Surgery.1999;6(2): 176–180.
Sakamoto Y, Nagai M, Tanaka N et al. Anatomical segmen- tectomy of the head of the pancreas along the embryological fusion plane: a feasible procedure?. Surgery.2000; 128(5): 822–831.
Tadokoro H, Kozu T, Toki F et al. Embryological fusion between the ducts of the ventral and dorsal primordia of the pancreas occurs in two manners. Pancreas. 1997; 14(4): 407–414.
Kamisawa T, Koike M, Okamoto A. Embryology of the pancreatic duct system. Digestion. 1999; 60(2): 161–165.
Todani T, Watanabe Y, Narusue M et al. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. American Journal of Surgery. 1977; 134(2):263–269.
Alonso-Lej F, Rever Jr WB, Pessagno DJ. Congenital choledochal cyst, with a report of 2, and an analysis of 94, cases. International Abstract of Surgery. 1959; 108(1): 1– 30.
Yamaguchi M, Congenital choledochal cyst. Analysis of 1,433 patients in the Japanese literature. American Journal of Surgery.1980; 140(5); 653–657.
Miyano T, Yamataka A, Choledochal cysts. Current Opinion in Pediatrics. 1997; 9(3): 283–288.
Weyant MJ, Maluccio MA, Bertagnolli MM et al. Choledochal cysts in adults: a report of two cases and review of the literature. American Journal of Gastroenterology. 1998; 93(22): 2580–2583.
Mercadier M, Chigot JP, Clot JP et al, Caroli’s disease. World Journal of Surgery. 1984; 8(1): 22–29.
Visser BC, Suh I, Way LW, et al. Congenital choledochal cysts in adults. Archives of Surgery. 2004; 139(8): 855– 862.
Matsumoto Y, Fujii H, Itakura J, et al. Recent advances in pancreaticobiliary maljunction. Journal of Hepato-Biliary-Pancreatic Surgery. 2002; 9(1): 45–54.
Kato O, Hattori K, Suzuki T, et al. Clinical significance of anomalous pancreaticobiliary union. Gastrointestinal Endoscopy. 1983; 29(2): 94–98.
Misra SP, Dwivedi M. Pancreaticobiliary ductal union. Gut. 1990; 31(10):1144–1149.
Yamauchi S, Koga A, Matsumoto S et al. Anomalous junction of pancreaticobiliary duct without congenital choledochal cyst: a possible risk factor for gallbladder cancer. American Journal of Gastroenterology.1987; 82(1): 20–24.
Nagata E, Sakai K, Kinoshita H, Kobayashi Y, The relation between carcinoma of the gallbladder and an anomalous connection between the choledochus and the pancreatic duct. Annals of Surgery. 1985;202(2): vol. 182–190.
Funabiki T, Matsubara T, Miyakawa S, Ishihara S, Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy. Langenbeck’s Archives of Surgery. 2009; 394(1): 159–169.
Matsumoto Y, Fujii H, Itakura J et al. Pancreaticobiliary maljunction: etiologic concepts based on radiologic aspects. Gastrointestinal Endoscopy. 2001; 53(6): 614–619.
Wong KC, Lister J, Human fetal development of the hepato-pancreatic duct junction—a possible explanation of congenital dilatation of the biliary tract. Journal of Pediatric Surgery.1981;16(2): 139–145.
Lainakis N, Antypas S, Panagidis A et al. Annular pancreas in two consecutive siblings: an extremely rare case. European Journal of Pediatric Surgery. 2005; 15(5): 364–368.
Gress F, Yiengpruksawan A, Sherman S. et al. Diagnosis of annular pancreas by endoscopic ultrasound. Gastrointestinal Endoscopy. 1996; 44(4): 485–489.
Sandrasegaran K, Patel A, Fogel EL et al.Annular pancreas in adults. American Journal of Roentgenology. 2009; 193(2): 455–460.
Ravitch MM, Woods Jr AC. Annular pancreas. Annals of Surgery. 1950; 132(6): 1116–1127.
Sessa F, Fiocca R, Tenti P et al. Pancreatic polypeptide rich tissue in the annular pancreas. A distinctive feature of ventral primordium derivatives. Virchows Archiv a Pathological Anatomy and Histology. 1983; 399(2): 227–232.
Suda K, Immunohistochemical and gross dissection studies of annular pancreas. Acta Pathologica Japonica. 1990; 40(7): 505–508.
Agha FP, Williams KD. Pancreas divisum: incidence, detection, and clinical significance. American Journal of Gastroenterology. 1987; 82(4): 315–320.
Lehman GA, Sherman S. Diagnosis and therapy of pancreas divisum. Gastrointestinal Endoscopy Clinics of North America. 1998; 8(1): 55–77.
Morgan DE, Logan K, Baron TH et al. Pancreas divisum: implications for diagnostic and therapeutic pancreatography. American Journal of Roentgenology. 1999; 173(1): 193–198.
Soto JA, Lucey BC, Stuhlfaut JW, Pancreas divisum: depiction with multi-detector row CT. Radiology. 2005; 235(2): 503–508.
Kamisawa T, Yuyang T, Egawa N, Ishiwata JI, Okamoto A, A new embryologic hypothesis of annular pancreas. Hepato-Gastroenterology. 2001; 48(37): 277– 278.
Nobukawa B, Otaka M, Suda K, et al.An annular pancreas derived from paired ventral pancreata, supporting Baldwin’s hypothesis,” Pancreas. 2000; 20(4): 408–410.
Cotton PB, Congenital anomaly of pancreas divisum as cause of obstructive pain and pancreatitis. Gut. 1980; 21(2): 105–114.
Warshaw AL, Simeone J, Schapiro RH et al. Objective evaluation of ampullary stenosis with ultrasonography and pancreatic stimulation. American Journal of Surgery.1985; 149(1): 65–72.
Cohen SA, Rutkovsky FD, Siegel JH, Kasmin FE, Endoscopic stenting and sphincterotomy of the minor papilla in symptomatic pancreas divisum: results and complications. Diagnostic and Therapeutic Endoscopy.1995; 1(3): 131– 139.
