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The document examines the association between pancreatic steatosis (SP) and post-ERCP pancreatitis. SP is identified as an important risk factor for the development of post-ERCP pancreatitis. The study shows that SP is an independent risk factor for post-ERCP pancreatitis. The results highlight the importance of quantifying SP by computed tomography to assess the risk of post-ERCP pancreatitis. [Extracted from the article]

Biliary and pancreatic diseases comprise a rich and varied corpus of pathologies. A particular entity is the dysfunction of the sphincter of Oddi. It is a diagnosis of elimination and is difficult to identify. It is most common in cholecystectomised patients who present with recurrent biliary pain. An equivalent on the pancreatic side is responsible for recurrent episodes of pancreatitis. The association of biliary or pancreatic pain, biological abnormalities -(cytolysis and cholestasis or hyperlipasemia) and biliary or pancreatic duct dilatation on imaging allows the diagnosis of sphincter of Oddi dysfunction. It is always -necessary to rule out the more common causes of biliary or pancreatic pain. Once the diagnosis has been made on clinical, biological and imaging grounds, sphincter of Oddi dysfunction is classified into three types according to the Milwaukee classification. This classification is used to guide therapy. The reference test is endoscopic manometry of the sphincter of Oddi, which measures the pressure in the biliary and/or pancreatic sphincters. Unfortunately, this type of test is -invasive and carries a significant risk of iatrogenic acute pancreatitis (11%). Biliary scintigraphy can replace manometry if it shows a prolonged transit time of bile between the hilum and the duodenum. Unfortunately, there is no equivalent to scintigraphy for investigating pancreatic sphincter of Oddi dysfunction. Pancreatic MRI with injection of secretin, which stimulates pancreatic secretion, may be an alternative but needs further investigation. Treatment of sphincter of Oddi dysfunction with biliary obstruction must be -primarily medical. Trimebutine can be suggested as a background treatment. The use of nitrates should be reserved for painful crises. Calcium channel blockers have also been studied in this indication. If medical treatment fails and with the exception of type III sphincter of Oddi dysfunction according to the Milwaukee classification, endoscopic sphincterotomy has a good effect on pain and in many cases allows it to disappear. The management of sphincter of Oddi dysfunction with pancreatic expression is more complex. Medical treatment remains a first step, but if it fails, double biliopancreatic sphincterotomy does not eliminate the pain in a large number of cases. Moreover, in this specific indication, endoscopic cholangiopancreatography exposes the patient to a higher risk of acute pancreatitis than in other pathologies, which requires good patient information on the benefits and risks involved, a trained operator and, finally, the application of the usual means of preventing post ERCP pancreatitis. [ABSTRACT FROM AUTHOR]

Aims: (1) To summarize current knowledge on the prevalence, intensity, and descriptors of orofacial pain and snoring/obstructive sleep apnea (OSA) before and after head and neck cancer (HNC) treatment; and (2) to propose future directions for research. Methods: The median prevalence for each condition was estimated from the most recent systematic reviews (SRs) and updated with new findings retrieved from the PubMed, Web of Science, Embase, and Cochrane databases up to December 2021. Results: The prevalence of HNC pain seems relatively stable over time, with a median of 31% before treatment in three studies to a median of 39% at 1 month to 16 years after treatment in six studies. HNC pain intensity remains mild to moderate. There was a threefold increase in temporomandibular pain prevalence after surgery (median 7.25% before to 21.3% after). The data for snoring prevalence are unreliable. The OSA/HNC prevalence seems relatively stable over time, with a median of 72% before treatment in three studies to 77% after treatment in 14 studies. Conclusion: With the exception of temporomandibular pain, the prevalence of HNC pain and OSA seems to be stable over time. Future studies should: (1) compare the trajectory of change over time according to each treatment; (2) compare individuals with HNC to healthy subjects; (3) use a standardized and comparable method of data collection; and (4) assess tolerance to oral or breathing devices, since HNC individuals may have mucosal sensitivity or pain. [ABSTRACT FROM AUTHOR]

CT and MR imaging features of fistulas from intraductal papillary mucinous neoplasms of the pancreas to adjacent organs: a retrospective study of 423 patients. An abdominal-pelvic computed tomography scan found major dilation of the common bile duct (measuring 27 mm) and of the main pancreatic duct (12 mm). B Video 1 b Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, showing dilation of the bile and pancreatic ducts by mucinous material, initial drainage, and subsequent placement of two double-pigtail plastic stents. [Extracted from the article]