BACKGROUND: Nesidioblastosis is often resistant to medical therapy and requires near-total pancreatectomy. There is little information on the postoperative imaging findings of these patients. OBJECTIVE: To demonstrate by US the late imaging findings in these patients. MATERIALS AND METHODS: Children diagnosed with nesidioblastosis and who had undergone 90-95% pancreatectomy received preoperative, immediate-postoperative (within 10 days of surgery) and long-term annual US examinations. In the preoperative study, three anterior-posterior (AP) measurements were obtained of the head, body and tail of the pancreas. In the postoperative and long-term follow-up US, AP and transverse measurements of the pancreatic remnant were obtained. Pancreatic echogenicity was also assessed. The results were compared with normal pancreatic dimensions as a function of age. Glucose metabolism and pancreatic enzymes were also analysed. RESULTS: The study group comprised 22 patients (aged 9 days to 2 years). The pancreas was normal in all preoperative US examinations. The first postoperative examination showed, in all patients, a remnant of the pancreatic head measuring 8-13 mm. The last follow-up US was similar to the first postoperative study in 6 patients, and 12 showed complete pancreatic regeneration (normal size, echogenicity and function), and 4 had incomplete regeneration with head and body normal in size, but lack of a pancreatic tail. All patients were asymptomatic and showed normal laboratory tests. CONCLUSIONS: US measurements indicated normal age-dependent growth after near-total resection in 54% of patients. The function and echogenicity of the regenerated pancreas indicate that the increase in organ size was due to normal pancreatic tissue.
BACKGROUND:Nesidioblastosis is often resistant to medical therapy and requires near-total pancreatectomy. There is little information on the postoperative imaging findings of these patients. OBJECTIVE: To demonstrate by US the late imaging findings in these patients. MATERIALS AND METHODS:Children diagnosed with nesidioblastosis and who had undergone 90-95% pancreatectomy received preoperative, immediate-postoperative (within 10 days of surgery) and long-term annual US examinations. In the preoperative study, three anterior-posterior (AP) measurements were obtained of the head, body and tail of the pancreas. In the postoperative and long-term follow-up US, AP and transverse measurements of the pancreatic remnant were obtained. Pancreatic echogenicity was also assessed. The results were compared with normal pancreatic dimensions as a function of age. Glucose metabolism and pancreatic enzymes were also analysed. RESULTS: The study group comprised 22 patients (aged 9 days to 2 years). The pancreas was normal in all preoperative US examinations. The first postoperative examination showed, in all patients, a remnant of the pancreatic head measuring 8-13 mm. The last follow-up US was similar to the first postoperative study in 6 patients, and 12 showed complete pancreatic regeneration (normal size, echogenicity and function), and 4 had incomplete regeneration with head and body normal in size, but lack of a pancreatic tail. All patients were asymptomatic and showed normal laboratory tests. CONCLUSIONS: US measurements indicated normal age-dependent growth after near-total resection in 54% of patients. The function and echogenicity of the regenerated pancreas indicate that the increase in organ size was due to normal pancreatic tissue.
Authors: T Ichikawa; M S Peterson; M P Federle; R L Baron; H Haradome; Y Kawamori; S Nawano; T Araki Journal: Radiology Date: 2000-07 Impact factor: 11.105
Authors: P de Lonlay; J C Fournet; J Rahier; M S Gross-Morand; F Poggi-Travert; V Foussier; J P Bonnefont; M C Brusset; F Brunelle; J J Robert; C Nihoul-Fékété; J M Saudubray; C Junien Journal: J Clin Invest Date: 1997-08-15 Impact factor: 14.808
Authors: M J Dunne; C Kane; R M Shepherd; J A Sanchez; R F James; P R Johnson; A Aynsley-Green; S Lu; J P Clement; K J Lindley; S Seino; L Aguilar-Bryan Journal: N Engl J Med Date: 1997-03-06 Impact factor: 91.245
Authors: C A Stanley; Y K Lieu; B Y Hsu; A B Burlina; C R Greenberg; N J Hopwood; K Perlman; B H Rich; E Zammarchi; M Poncz Journal: N Engl J Med Date: 1998-05-07 Impact factor: 91.245
Authors: T Otonkoski; C Ammälä; H Huopio; G J Cote; J Chapman; K Cosgrove; R Ashfield; E Huang; J Komulainen; F M Ashcroft; M J Dunne; J Kere; P M Thomas Journal: Diabetes Date: 1999-02 Impact factor: 9.461
Authors: J Rahier; C Sempoux; J C Fournet; F Poggi; F Brunelle; C Nihoul-Fekete; J M Saudubray; F Jaubert Journal: Histopathology Date: 1998-01 Impact factor: 5.087