抄録
A comparative study of pancreatograms, three-dimensional reconstructions of the pancreatic ducts and histological findings was performed in chronic pancreas injury dogs following Freund's complete adjuvant injection. 1. Abnormal pancreatograms consisted of dilatation (simple, undulatory, bead-like), irregularity and stenosis. 2. In normal pancreatograms, three-dimensional representation of the ducts were cylindric and smooth in surface. Histological findings of the pancreatic ducts and adjacent parenchyma were almost normal. 3. Reconstructed ducts of simple dilatation in pancreatograms were cylindric, smooth in surface and enlarged in diameter. The histological study showed severe dilated ducts with flattened epithelia. In addition to, periductal and interlobular fibrosis with slight inflammatory cell infiltration was observed. 4. Three-dimensionally reconstructed figures of undulatory dilated ducts showed slight tortuosity of main ducts, and distorsion, dilatation and anastomosis in some of branches. Histological findings of the tortuous regions showed slight irregularity of the lumen, but no remarkable changes of epithelia were observed. Inter and intralobular fibrosis with inflammatory cell infiltration often invaded the lobules, although periductal fibrosis was generally slight. 5. Three-dimensional representations of the bead-like dilatation showed severe tortuosity, and irregularity and uneven surface. Branches were increased in number, tortuous, communicated with one another and some of them disappeared suddenly. Histologically, the ducts showed irregular lumina and many ramifications, but papillary hyperplasia or metaplasia of epithelia was not revealed. Inter-and intralobular fibrosis with inflammation and parenchymal destruction were severe. In summary, this study showed that bead-like dilatation in pancreatograms was a result of severe chronic pancreatic injury, and correlated closely with “distorsion” of the pancreatic ducts due to pancreatic strain which was attributed to parenchymal destruction and fibrosis with inflammation rather than caliber variations and epithelial changes. Furthermore, the pathogenesis of the undulatory changes of the ducts might be a same mechanism.
