Use of methylene blue to identify the minor papilla or its orifice in patients with pancreas divisum

Sang Heum Park, Mario De Bellis, Lee McHenry, Evan Fogel, Laura Lazzell, Lois Bucksot, Stuart Sherman, Glen Lehman

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: In some patients with pancreas divisum, minor papilla cannulation is difficult because of uncertain identification of the papilla or its orifice, even after pancreatic secretory stimulation with secretin or cholecystokinin agonist. Methods: Two techniques with methylene blue were used to identify the minor papilla and its orifice more clearly in a series of patients: spraying methylene blue over duodenal mucosa in the region suspected to contain the minor papilla with/without secretin or cholecystokinin agonist administration, and injection of contrast medium containing methylene blue into the ventral pancreatic duct by means of the major papilla in cases of incomplete pancreas divisum. Results were reviewed retrospectively. Results: From January 2001 to May 2002, minor papilla cannulation with conventional methods initially failed in 38 of 305 patients with pancreas divisum because of an inconspicuous minor papilla orifice. Methylene blue was used to identity the minor papilla orifice in 14 of 38 patients (spraying, 13; injection, 1). Minor papilla cannulation was successful in 12 of 14 (86%) patients (spraying 11, injection 1). Mild pancreatitis developed in 1 patient. Conclusions: Methylene blue spraying or injection appears to be a helpful technique for identification of the inconspicuous minor papilla orifice in patients with pancreas divisum.

Original languageEnglish
Pages (from-to)358-363
Number of pages6
JournalGastrointestinal Endoscopy
Volume57
Issue number3
DOIs
StatePublished - Mar 1 2003

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Methylene Blue
Pancreas
Catheterization
Injections
Secretin
Cholecystokinin
Pancreatic Ducts
Pancreatitis
Contrast Media
Mucous Membrane

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Use of methylene blue to identify the minor papilla or its orifice in patients with pancreas divisum. / Park, Sang Heum; De Bellis, Mario; McHenry, Lee; Fogel, Evan; Lazzell, Laura; Bucksot, Lois; Sherman, Stuart; Lehman, Glen.

In: Gastrointestinal Endoscopy, Vol. 57, No. 3, 01.03.2003, p. 358-363.

Research output: Contribution to journalArticle

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AU - Bucksot, Lois

AU - Sherman, Stuart

AU - Lehman, Glen

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