Meandering main pancreatic duct

Last revised by Daniel J Bell on 20 Feb 2024

Meandering main pancreatic duct (MMPD) denotes a main pancreatic duct that drains normally into the major papilla but performs a hairpin turn (reverse Z-type) or loop (loop-type) in the pancreatic head, in contradistinction to the smooth curvature seen in most cases.

These ductal variants are found on ERCP and MRCP studies. Their exact incidence is not known.

Significantly increased incidence of meandering pancreatic duct has been reported in patients with idiopathic recurrent acute pancreatitis (40%) compared with the general population (2.2%) 1.

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