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The aim of this study was to clarify the usefulness of magnetic resonance cholangiopancreatography (MRCP) for the evaluation of choledochal cyst in children.MRCP was performed preoperatively in 33 patients. The MRCP findings were compared with those of endoscopic retrograde cholangiopancreatography or intraoperative cholangiopancreatography.In all 33 patients, MRCP could detect choledochal cyst. The detection rate of a cyst in the main pancreatic duct was 62.2%, of abnormal union of the pancreaticobiliary junction (AUPBJ) was 53.3%, of dilatation or abnormalities of the main pancreatic duct was 75.0% and of a protein plug or stone was 76.9%. In patients under 2 years of age (group A), these findings were significantly lower than those of patients above 2 years of age (group B) [main pancreatic duct: 16.6% (1/6) vs 73.1% (19/26), P0.01; AUPBJ: 0.0% (0/6) vs 66.7% (16/24), P0.05; and protein plug or stone: 0.0% (0/2) vs 90.9% (10/11), P0.05]. The detection rate of AUPBJ in the patients with fusiform dilatation was superior to that of those with cystic dilatation [70% (14/20) vs 20% (2/10), P0.05]. In the patients with fusiform dilatation, the detection rate in group A was significantly lower than that in group B [0.0% (0/3) vs 82.4% (14/17), P0.01]; however, there was no significant difference between the 2 groups in the detection of cystic dilatation.In patients older than 2 years, MRCP should be the first-choice method for confirming the diagnosis and for ensuring accurate visualization of the pancreaticobiliary system.

Background: n-3 Polyunsaturated fatty acids (PUFAs) have been suggested as a treatment for ulcerative colitis (UC). However, the efficacy of n-3 PUFAs against UC has not been examined in children. Therefore, the authors investigated the effects of eicosapentaenoic acid (EPA) on fatty acid composition and leukotriene (LT) production in children with UC. Methods: For 2 months the authors administered highly purified EPA ethyl ester (EPA-E) (1.8 g/d) to children with UC in remission. Colonic mucosal histology, fatty acid composition of erythrocyte membrane phospholipids, and LTB 4 production by leukocytes and colonic mucosa were measured before and 2 months after the initiation of EPA-E treatment. Results: No patients relapsed during the study period, and no significant differences were detected in laboratory findings obtained before and 2 months after the initiation of EPA-E ingestion. There were no significant differences in mucosal histologic scores before and 2 months after EPA-E treatment. The EPA levels in erythrocyte membranes 2 months after the initiation of EPA-E treatment were significantly higher than before treatment, but the other fatty acids showed no significant changes. LTB 4 production by leukocytes and rectal mucosa after 2 months of EPA-E treatment was significantly lower than before treatment. Conclusion: EPA-E treatment increased the levels of EPA in erythrocytes and decreased LTB 4 levels produced by leukocytes and colonic mucosa. To assess the concomitant clinical changes, we should examine the long-term effects of EPA-E ingestion on the maintenance of remission in children with UC.