Learning objectives
Our purpose is to highlight the most common congenital anomalies and normal variants of pancreatic ductal system and their clinical relevance.
We have also described MR-cholangiopancreaticography (MRCP) features of these conditions.
Background
A developmental anomaly of the main pancreatic duct should be considered in patients with unexplained recurrent pancreatitis [1].MRCP is the first-choice technique to perform a noninvasive evaluation of the biliary tree and pancreatic duct and to indicate the most proper treatment [2].
Findings and procedure details
We have revised the most significant articles regarding congenital anomalies of pancreatic ductal system; we have also performed a search in the radiological and pathological databases of our Institution.
The most frequent condition is pancreas divisum,
depicted in about 10-15% of general population (Figure 1): it results from a failure of ventral and dorsal pancreatic bud fusion during embryological life [2].The majority of the gland empties into the minor papilla through the dorsal (Santorini) duct.
Some patients are totally asymptomatic,
but several present recurrent pancreatic...
Conclusion
Anomalies of pancreatic ductal system are common,
but only a minority is symptom related.
Recognition of these entities is important in clinical management and for avoiding misdiagnosis.
MR-cholangiopancreaticography is indicated to identify these conditions and to plan the most proper treatment.
References
1 Borghei P,
Sokhandon F,
Shirkhoda A,
Morgan DE (2013) Anomalies,
anatomic variants,
and sources of diagnostic pitfalls in pancreatic imaging.
Radiology 266:28-36
2 Boninsegna E,
Manfredi R,
Ventriglia A et al (2015) Santorinicele: secretin-enhanced magnetic resonance cholangiopancreatography findings before and after minor papilla sphincterotomy.
Eur Radiol 25:2437-2444
3 Matos C,
Metens T,
Deviere J,
Delhaye M,
Le Moine O,
Cremer M (2001) Pancreas divisum: evaluation with secretin-enhanced magnetic resonance cholangiopancreatography.
Gastrointest Endosc 53:728-733
4 Mortele KJ,
Rocha TC,
Streeter JL,
Taylor AJ (2006) Multimodality...