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Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin

BACKGROUND: To determine the effect of intramuscular administration of Neostigmine(®) on the visualization of the pancreatic duct on magnetic resonance cholangiopancreatography in patients with recurrent acute pancreatitis or abdominal pain. METHODS: We reviewed patients undergoing magnetic resonanc...

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Autores principales: Toledo, Paulina F., Cárdenas, Gonzalo, Berger, Zoltán, Simian, Daniela, Araya, Francisca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Society of Gastroenterology 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524412/
https://www.ncbi.nlm.nih.gov/pubmed/35946885
http://dx.doi.org/10.5152/tjg.2022.21864
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author Toledo, Paulina F.
Cárdenas, Gonzalo
Berger, Zoltán
Simian, Daniela
Araya, Francisca
author_facet Toledo, Paulina F.
Cárdenas, Gonzalo
Berger, Zoltán
Simian, Daniela
Araya, Francisca
author_sort Toledo, Paulina F.
collection PubMed
description BACKGROUND: To determine the effect of intramuscular administration of Neostigmine(®) on the visualization of the pancreatic duct on magnetic resonance cholangiopancreatography in patients with recurrent acute pancreatitis or abdominal pain. METHODS: We reviewed patients undergoing magnetic resonance cholangiopancreatography followed by a Neostigmine(®)-enhanced magnetic resonance cholangiopancreatography. Patients with a history of recurrent acute pancreatitis or abdominal pain who had a magnetic resonance cholangiopancreatography where the pancreatic duct was not entirely seen, were selected to undergo a second magnetic resonance cholangiopancreatography 40 minutes after 0.5 mg Neostigmine(®). Images were analyzed by 2 radiologists. The diameter of the pancreatic duct was measured in the head, body, and tail of the pancreas on the baseline images and after Neostigmine(®). RESULTS: Ten patients were included, with a median age of 33 years (range 15-61). The maximum diameter of the pancreatic duct increased significantly after Neostigmine(®) administration in all patients, from 1.84 ± 0.98 to 3.41 ± 1.27 mm in the head, 1.34 ± 0.42 mm to 2.5 ± 0.49 mm in the body and 0.72 ± 0.52 mm to 1.78 ± 0.43 mm in the tail (mean ± SD, P < .0001). Neostigmine(®) helped to provide better detail of the pancreatic duct anatomy in 4 patients. In 2 patients we confirmed pancreas divisum, in another the Santorini duct was not seen on the baseline images but it was clearly visualized after Neostigmine(®), and in the fourth patient, Neostigmine(®) improved visualization of multiple pancreatic duct stenosis. CONCLUSION: Neostigmine(®)-magnetic resonance cholangiopancreatography significantly increases the diameter of the pancreatic duct, allowing an accurate morphological evaluation. It could be a cheap alternative to secretin, which is expensive and hardly available.
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spelling pubmed-95244122022-10-13 Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin Toledo, Paulina F. Cárdenas, Gonzalo Berger, Zoltán Simian, Daniela Araya, Francisca Turk J Gastroenterol Original Article BACKGROUND: To determine the effect of intramuscular administration of Neostigmine(®) on the visualization of the pancreatic duct on magnetic resonance cholangiopancreatography in patients with recurrent acute pancreatitis or abdominal pain. METHODS: We reviewed patients undergoing magnetic resonance cholangiopancreatography followed by a Neostigmine(®)-enhanced magnetic resonance cholangiopancreatography. Patients with a history of recurrent acute pancreatitis or abdominal pain who had a magnetic resonance cholangiopancreatography where the pancreatic duct was not entirely seen, were selected to undergo a second magnetic resonance cholangiopancreatography 40 minutes after 0.5 mg Neostigmine(®). Images were analyzed by 2 radiologists. The diameter of the pancreatic duct was measured in the head, body, and tail of the pancreas on the baseline images and after Neostigmine(®). RESULTS: Ten patients were included, with a median age of 33 years (range 15-61). The maximum diameter of the pancreatic duct increased significantly after Neostigmine(®) administration in all patients, from 1.84 ± 0.98 to 3.41 ± 1.27 mm in the head, 1.34 ± 0.42 mm to 2.5 ± 0.49 mm in the body and 0.72 ± 0.52 mm to 1.78 ± 0.43 mm in the tail (mean ± SD, P < .0001). Neostigmine(®) helped to provide better detail of the pancreatic duct anatomy in 4 patients. In 2 patients we confirmed pancreas divisum, in another the Santorini duct was not seen on the baseline images but it was clearly visualized after Neostigmine(®), and in the fourth patient, Neostigmine(®) improved visualization of multiple pancreatic duct stenosis. CONCLUSION: Neostigmine(®)-magnetic resonance cholangiopancreatography significantly increases the diameter of the pancreatic duct, allowing an accurate morphological evaluation. It could be a cheap alternative to secretin, which is expensive and hardly available. Turkish Society of Gastroenterology 2022-08-01 /pmc/articles/PMC9524412/ /pubmed/35946885 http://dx.doi.org/10.5152/tjg.2022.21864 Text en © Copyright 2022 authors https://creativecommons.org/licenses/by/4.0/ Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Original Article
Toledo, Paulina F.
Cárdenas, Gonzalo
Berger, Zoltán
Simian, Daniela
Araya, Francisca
Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin
title Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin
title_full Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin
title_fullStr Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin
title_full_unstemmed Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin
title_short Neostigmine(®) Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin
title_sort neostigmine(®) improves pancreatic duct visualization in magnetic resonance cholangiopancreatography and could be a cheap alternative for secretin
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524412/
https://www.ncbi.nlm.nih.gov/pubmed/35946885
http://dx.doi.org/10.5152/tjg.2022.21864
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