Ct Angio And Tortuous Veins At Base Of Skull

62.51-Hi e

Fig. 2-50. Annular pancreas.

A 44-year-old man presented with abdominal pain.

(a) Upper GI series shows a localized stenosis of the descending duodenum (arrows).

(b and c) Enhanced CT scans and MR images (d and e) show pancreatic tissue (arrows) encircles the descending duodenum (D).

Annular Pancreas

Fig. 2—51. Annular pancreas.

Coned-down view from a supine radiograph of the abdomen shows an air-filled duodenal sweep. A short constriction is noted in the proximal descending portion (arrows) secondary to the presence of an annular pancreas. (From Jadvar H, Mindelzun RE.90)

Fig. 2—51. Annular pancreas.

Coned-down view from a supine radiograph of the abdomen shows an air-filled duodenal sweep. A short constriction is noted in the proximal descending portion (arrows) secondary to the presence of an annular pancreas. (From Jadvar H, Mindelzun RE.90)

Annular Pancreas Ercp

Fig. 2-52. Pancreas divisum.

Cannulation of the major papilla during an ERCP opacifies the small ductal system (curved arrow) of the ventral pancreatic bud. Previous cannulation of the minor papilla had opacified the much larger and noncommuni-cating accessory duct (straight arrow) arising from the dorsal pancreatic anlage in this patient with a pancreas divisum. (From Javors BR.3)

Tarry Stool

Fig. 2-53. Pancreas divisum with focal pancreatitis of ventral anlage presenting with bleeding in the pancreatic duct.

A 55-year-old woman with history of recurrent tarry stool for several years presented with acute GI tract bleeding.

(a) Endoscopic retrograde injection of contrast medium into the major papilla shows filling defects within the dilated branches of the ventral ducts representing blood clots (arrows).

(b and c) ERCP performed 2 weeks later confirms pancreas divisum.

Multiphase dynamic CT scans (d) taken at 30 sec and (e) at 180 sec after the start of infusion of intravenous contrast medium show early enhancement of dorsal anlage (straight arrows) and late enhancement of ventral anlage (curved arrows). Partial pancreatectomy revealed chronic pancreatitis with moderate fibrosis of the ventral anlage.

Fig. 2-53. Pancreas divisum with focal pancreatitis of ventral anlage presenting with bleeding in the pancreatic duct.

A 55-year-old woman with history of recurrent tarry stool for several years presented with acute GI tract bleeding.

(a) Endoscopic retrograde injection of contrast medium into the major papilla shows filling defects within the dilated branches of the ventral ducts representing blood clots (arrows).

(b and c) ERCP performed 2 weeks later confirms pancreas divisum.

Multiphase dynamic CT scans (d) taken at 30 sec and (e) at 180 sec after the start of infusion of intravenous contrast medium show early enhancement of dorsal anlage (straight arrows) and late enhancement of ventral anlage (curved arrows). Partial pancreatectomy revealed chronic pancreatitis with moderate fibrosis of the ventral anlage.

Dorsal Pancreatic Agenesis

Fig. 2-54. Agenesis of the dorsal pancreas.

A 66-year-old woman presented with abdominal pain and mild diabetes mellitus. (a) ERCP shows a short, tortuous pancreatic duct (arrow).

(b to d) Enhanced CT scans show a round-shaped head of the pancreas (curved arrows) without evidence of the body and tail of the pancreas ventral to the splenic vein (straight arrows). There is minimal dilatation of the pancreatic duct in the head and neck of the pancreas but no evidence of pancreatic duct in the region of the body and tail.

Fig. 2-54. Agenesis of the dorsal pancreas.

A 66-year-old woman presented with abdominal pain and mild diabetes mellitus. (a) ERCP shows a short, tortuous pancreatic duct (arrow).

(b to d) Enhanced CT scans show a round-shaped head of the pancreas (curved arrows) without evidence of the body and tail of the pancreas ventral to the splenic vein (straight arrows). There is minimal dilatation of the pancreatic duct in the head and neck of the pancreas but no evidence of pancreatic duct in the region of the body and tail.

Straight Neck Mri Scan

Fig. 2—55. Arteriovenous malformation in the region of the head of the pancreas.

A 34-year-old man presented with recurrent duodenal ulcer.

(a) CT scan at artery-dominant phase shows an intense enhancement of the region of the head of the pancreas (arrows). SMV = superior mesenteric vein.

(b) Tl-weighted MRI demonstrates an area of signal void in the head of the pancreas (arrows).

(c and d) Angiography reveals arteriovenous malformation (curved arrows) in the head of the pancreas fed by pancreatic and duodenal arteries and draining to pancreaticoduodenal veins and the superior mesenteric vein.

Fig. 2—55. Arteriovenous malformation in the region of the head of the pancreas.

A 34-year-old man presented with recurrent duodenal ulcer.

(a) CT scan at artery-dominant phase shows an intense enhancement of the region of the head of the pancreas (arrows). SMV = superior mesenteric vein.

(b) Tl-weighted MRI demonstrates an area of signal void in the head of the pancreas (arrows).

(c and d) Angiography reveals arteriovenous malformation (curved arrows) in the head of the pancreas fed by pancreatic and duodenal arteries and draining to pancreaticoduodenal veins and the superior mesenteric vein.

Dynamic Renal ScanAngio Bln Vein
* JM

Fig. 2-56. Pancreatic cysts and renal carcinomas in von Hippel-Lindau disease.

A 48-year-old woman had a family history of von Hippel-Lindau disease.

(a to c) T2-weighted and postcontrast T1-weighted MR images show multiple cysts of the pancreas (arrows) and a mass of the right kidney (curved arrows).

(d and e) CT scans demonstrate pancreatic cysts (arrows) and another mass of the right kidney (curved arrow). Right nephrectomy revealed multiple renal cell carcinomas of the right kidney.

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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