The usefulness of texture and color enhancement imaging to identify the minor papilla orifice

© 2024 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society..

In clinical cases of pancreas divisum, endoscopic retrograde cholangiopancreatography often necessitates cannulation of the pancreatic duct through the minor papilla. Nevertheless, this procedure can be challenging because of the small size of the minor papilla and the difficulty in visualizing the ductal orifice. A new image-enhanced endoscopy technique called texture and color enhancement imaging (TXI) has been developed, which enhances texture, brightness, and color compared with white-light imaging, resulting in subtle differences in the surface mucosa. Herein, we describe the case of a 73-year-old man with pancreas divisum in whom TXI was useful in identifying the orifice of the minor papilla. He was referred to our hospital with repetitive acute exacerbation of chronic pancreatitis. Since contrast-enhanced computed tomography revealed a pancreatic stone in the main pancreatic duct, endoscopic retrograde cholangoepancreatography was performed as a therapeutic intervention. Despite the initial difficulty in identifying the orifice of the minor papilla on white-light imaging, TXI enhanced its visibility successfully, enabling dorsal pancreatic duct cannulation via the minor papilla. Subsequently, endoscopic pancreatic sphincterotomy was performed and a 6Fr plastic stent was placed. Post-endoscopic therapy, the patient's abdominal pain was relieved. TXI was useful in identifying the minor papilla orifice and led to successful cannulation.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:4

Enthalten in:

DEN open - 4(2024), 1 vom: 30. Apr., Seite e358

Sprache:

Englisch

Beteiligte Personen:

Goda, Yoshihiro [VerfasserIn]
Irie, Kuniyasu [VerfasserIn]
Anan, Hideyuki [VerfasserIn]
Suzuki, Yuichi [VerfasserIn]
Ikeda, Aya [VerfasserIn]
Ikeda, Ryosuke [VerfasserIn]
Kaneko, Hiroaki [VerfasserIn]
Sue, Soichiro [VerfasserIn]
Miwa, Haruo [VerfasserIn]
Maeda, Shin [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Endoscopic retrograde cholangiopancreatography
Minor papilla
Pancreas divisum
Pancreatic duct
Texture and color enhancement imaging

Anmerkungen:

Date Revised 09.04.2024

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1002/deo2.358

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM37075669X