Pancréas parasitaire

The parasitic pancreas is a many-faceted entity, the study of which leads to review many nosologic settings. Internal organ not involved in the cycles of parasitic replication as opposed to what one observes for the liver and the digestive tract, the pancreas can however be concerned by cosmopolitan or exotic various parasites. Parasites as usual hosts of the small intestine or bile ducts can cause pancreatic duct obstruction after migration into the Vater ampulla or Wirsung’s canal; other parasites, from digestive or extra digestive origin, more rarely can cause lesions of the pancreatic parenchyma secondarily to unusual migration or blood infection. A systemic mechanism is more exceptionally involved, as during serious attacks of malaria or induced by the pancreatic toxicity of anti-parasitic drugs. The context of immunodepression may evoke opportunist parasites and the possibility of parasitic transmission by pancreatic transplantation. Anatomic and clinical features are eminently variable, oscillating between epiphenomenon of fortuitous or autopsic discovery until potentially serious demonstrations, as acute pancreatitis being able to engage vital prognosis. The whole set of therapeutic tools consists mainly in anti-parasitic chemotherapies, in combination with endoscopic retrograde cholangio-pancreatography or surgery in selected indications.