Leger L
Nouv Presse Med. 1979 Jan 20;8(3):175-80.
The existence of dilatation of the Wirsung duct distal to an isthmic calculus, the marked dilatation of the cephalic portion of the duct contrasting with the sub-normal calibre of the corporeo-caudal duct in a case of pancreatic lithiasis, are all against the pathogenic hypothesis of a retrodilatation proximal to an obstruction, a supposition which is apparently satisfactory but not always confirmed by the facts. Thus duct distension would not seem to be a purely mechanical phenomenon. The confusing topography of sectorial dilatation of the Wirsung duct in chronic pancreatitis may be explained by a process affecting in isolation or predominantly one or another embryonic sector. The paradox of the association of cephalic dilatation of the duct with stenosis of the intrapancreatic common bile duct offers further support for this hypothesis.
在胰管结石病例中，胰腺管壶腹远端存在扩张，与体尾段胰管管径低于正常形成对比，这均与梗阻近端逆行扩张的致病假说相悖，该假说表面上令人满意，但并非总能得到事实证实。因此，胰管扩张似乎并非纯粹的机械现象。慢性胰腺炎中胰腺管节段性扩张的复杂形态，可能是由单独或主要影响一个或另一个胚胎节段的过程所解释。胰腺管头部扩张与胰内胆总管狭窄并存的矛盾现象，为这一假说提供了进一步支持。
