Endoskopie heute 2013; 26 - P57
DOI: 10.1055/s-0033-1334031

Pancreas mobile, good to know

C De Molo 1, XW Cui 1, C Pirri 1, A Ignee 1, M Hocke 1, D Schreiber-Dietrich 1, CF Dietrich 1
  • 1Caritas Krankenhaus, Innere Medizin 2, Bad Mergentheim, Germany

Background and Aim: Up to now, little is known about the mobility of the pancreas due to changes in posture. The present study was conducted to assess the position of the pancreas in the left recumbent posture (endoscopy posture), the pancreatic mobility during changes of the posture from supine to endoscopy posture and also evaluates the possible factors associated with pancreatic mobility.

Methods: 199 patients with or without chronic pancreatitis were examined using conventional gray-scale transabdominal ultrasound to image the position and mobility of the pancreatic head with reference to the vertebral spine and aorta in the supine and left recumbent position. In a subgroup of 75 patients, the exact moving distance of the central line of the pancreatic head from the supine to left recumbent position was obtained regarding the central line of the spine as the reference. Besides the 199 patients, 50 patients without pancreatic pathology were evaluated by endoscopic ultrasound with radial transducers.

Results: On conventional ultrasound in supine (left lateral) position the percentage of patients with right-aortal, pre-aortal, left-aortal pancreatic head were 91.0% (49%), 8.0% (31%) and 1.0% (20%), respectively. Significant movement of the pancreatic head in relation to the aorta was observed in 48% patients. The moving distance was correlated to the age, sex and the presence of chronic pancreatitis. Pancreas mobility was more pronounced in young healthy females. No association was found between the moving distance and the body mass index (BMI) and splenic size. On endoscopic ultrasound, the orientation of the pancreas with a view of more (or equal) than 180o was observed in 48% and less than 180o in 52% of patients.

Conclusion: Pancreas mobile is a common phenomenon (about 50%) which has not often been recognized in daily routine. This phenomenon is more likely in healthy young females. The knowledge of pancreas mobile is of utmost importance during the endoscopic ultrasound examination and in the diagnosis of peripancreatic infiltration.