The diagnosis of chronic pancreatitis remains difficult in spite of the various methods of examination.
In this report, the diagnostic value of the cholangiogram in chronic pancreatitis is studied from clinical observations of 107 cases of miscellaneous disease including 25 cases of chronic pancreatitis, and to clarify the significance of the cholangiogram the histological relationship between the duodenal papilla and the pancreas from autopsy materials is studied.
The results are as follows:
1. Cholangiograms associated with chronic pancreatitis are classified into the four types from deformities of the pancreatic segment of common duct.
1) Type of rigidity and straightening
2) Type of rigidity and spindle-form
3) Type of reversed C curve
4) Type of localized stenosis
2. The cholangiographic types concern the pathogenesis of chronic pancreatitis. The rigidity and straightening type closely correlates with alcoholic pancreatitis and the rigidity and spindle-form type closely correlates with biliary pancreatitis.
3. Concerning the diagnostic validity of chronic pancreatitis from cholangiograms classified into the four types, the false negative is observed in 13.0% and the false positive is observed in 28.6%.
4. The duodenal papillae with cholelithiasis freqently show diffuse fibrosis and round cell infiltration.
5. Diffuse chronic inflammatory changes in the duodenal papillae correlate with the pancreatic round cell infiltration.
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