Digestive and Liver Disease
Volume 42, Issue 2 , Pages 92-98 , February 2010

Autoimmune pancreatitis: A challenging diagnostic puzzle for clinicians

  • E. Buscarini

      Affiliations

    • Gastroenterology Department, Maggiore Hospital, Largo Dossena 2, 26013 Crema, Italy
    • Corresponding Author InformationCorresponding author. Tel.: +39 0373 280320; fax: +39 0373 280654.
    • ,
  • L. Frulloni

      Affiliations

    • Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy
    • ,
  • S. De Lisi

      Affiliations

    • Cattedra & Unità Operativa di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
    • ,
  • M. Falconi

      Affiliations

    • Department of Anesthesiological and Surgical Sciences, University of Verona, Verona, Italy
    • ,
  • P.A. Testoni

      Affiliations

    • Gastroenterology Department, I.R.C.C.S San Raffaele, University Vita e Salute San Raffaele, Milan, Italy
    • ,
  • A. Zambelli

      Affiliations

    • Gastroenterology Department, Maggiore Hospital, Largo Dossena 2, 26013 Crema, Italy

Received 1 August 2009 ,Accepted 27 August 2009.

  • Image Result

    AIP, diffuse form. Transverse epigastric US scan reveals a diffusely and substantially enlarged pancreas (arrows) with echo-poor echotexture and normal sized main pancreatic duct (arrowheads); SV=sple

    AIP, diffuse form. Transverse epigastric US scan reveals a diffusely and substantially enlarged pancreas (arrows) with echo-poor echotexture and normal sized main pancreatic duct (arrowheads); SV=splenic vein.

  • Image Result
    AIP, diffuse form. Contrast-enhanced CT shows the diffuse pancreatic swelling (arrows).

    AIP, diffuse form. Contrast-enhanced CT shows the diffuse pancreatic swelling (arrows).

  • Image Result
    AIP, focal form. Contrast-enhanced CT shows an enlarged pancreatic body and tail (arrows).

    AIP, focal form. Contrast-enhanced CT shows an enlarged pancreatic body and tail (arrows).

  • Image Result
    A contrast-enhanced axial CT scan (a and b) shows that the pancreatic gland (arrowheads) is swollen with some hypodense areas (arrows).The CT check (c and d) after 6 weeks of steroid treatment shows t

    A contrast-enhanced axial CT scan (a and b) shows that the pancreatic gland (arrowheads) is swollen with some hypodense areas (arrows).

    The CT check (c and d) after 6 weeks of steroid treatment shows the marked decrease in size of the gland, either head or body and tail (arrowheads).

  • Image Result
    AIP, with common bile duct involvement: endoscopic retrograde cholangiography shows a stenosis of the distal common bile duct (arrows).

    AIP, with common bile duct involvement: endoscopic retrograde cholangiography shows a stenosis of the distal common bile duct (arrows).

  • Image Result
    Linear EUS (a) shows a focal roundish echo-poor lesion (arrows) in the pancreatic head (PH), and the common bile duct (arrowheads) has a diffusely thickened wall. The bile duct wall thickening (arrows

    Linear EUS (a) shows a focal roundish echo-poor lesion (arrows) in the pancreatic head (PH), and the common bile duct (arrowheads) has a diffusely thickened wall. The bile duct wall thickening (arrows) (b) has a “sandwich-pattern”, with an intermediate echo-poor layer and echo-rich inner and outer layers. PV=portal vein.

PII: S1590-8658(09)00362-4

doi: 10.1016/j.dld.2009.08.006

Digestive and Liver Disease
Volume 42, Issue 2 , Pages 92-98 , February 2010

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