MULTIMEDIA ARTICLE – Clinical Imaging

 

 

Horseshoe Shaped Pancreas

 

 

Tatsuya Kin, AM James Shapiro

 

 

Clinical Islet Laboratory and Clinical Islet Transplant Program, University of Alberta. Edmonton, Alberta, Canada

 

 

A 20-year-old male with intracerebral bleeding due to a motor vehicle accident as the cause of death became a multiorgan donor. He did not have any notable medical history including pancreas disease. The pancreas was procured en bloc with the spleen and duodenum at a distant hospital and shipped to our institute for the purpose of islet isolation and transplantation. During a routine preparation of the pancreas prior to islet isolation, the uncinate process was found to extend along with the third portion of the duodenum to left side of the supra mesenteric vein, forming an elongated unusual lobe. The whole pancreas was horseshoe shaped (Image: the arrowhead points a catheter inserted into the orifice of Wirsung’s duct). The term “horseshoe pancreas” is not new. In 1960s, when radioisotope scanning of the pancreas was under development, some researchers used this term to describe one of several morphological types of the pancreas [1]. The term is also seen in the early image literature to describe the pancreatic ductal configuration [2]. A feature of these previously described “horseshoe pancreas” is a left-right symmetric type where the tail is oriented inferiorly. This is totally different from cases of ours and others [3]: a superior-inferior symmetric type. Surgeons should be aware that the uncinate process can extend and form an elongated lobe as this variant may impact the surgical approach.

 

 

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Received October 31st, 2013 – Accepted November 8th, 2013

Key words Islets of Langerhans; Islets of Langerhans Transplantation; Tissue Donors

Conflict of interest The authors declare no conflict of interest

Correspondence
Tatsuya Kin
Clinical Islet Laboratory
University of Alberta
210 College Plaza, 8215 - 112th St.
Edmonton, Alberta, T6G 2C8
Canada
Phone: +1-780.407.8671
Fax: +1-780.407.8760
E-mail: tkin@ualberta.ca

 

 

References

1.   Colella AC, Pigorini F. Experiences in pancreas scanning using 75-Se-selenomethionine. Br J Radiol 1967; 40:662-9. [PMID 4291800].

2.   Kreel L, Sandin B, Slavin G. Pancreatic morphology – a combined radiological and pathological study. Clin Radiol 1973; 24:154-61. [PMID 4733275].

3.   Yazu T, Kimura T, Yamamoto K, Sumii T, Arita Y, Takano S, et al. Horseshoe anomaly of the pancreas. Pancreas 1992; 7:503-6. [PMID 1641393].