Pancreatic duct diameter
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At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Ciléin Kearns had no financial relationships to ineligible companies to disclose.
View Ciléin Kearns's current disclosures- Diameter of pancreatic duct
- Diameter of the pancreatic duct
- Pancreatic ductal diameter
- Duct of Wirsung diameter
The diameter of the (main) pancreatic duct is a commonly assessed parameter in imaging.
Gross anatomy
The duct diameter is greatest at the head and neck region and is slightly narrower towards the body and tail. Its normal reported value ranges between 1-3.5 mm in <50 year old and 2-5 mm in 70-79 year old individuals with mean reported values (rounded to the nearest 0.5 mm) being 5,8,11:
-
head
3.5 mm (<50 years)
5 mm (70-79 years)
-
body
2.5 mm (<50 years)
3 mm (70-79 years)
-
tail
1.5 mm (<50 years)
2 mm (70-79 years)
Pancreatic duct diameter may also increase by 1.0-2.2 mm with deep inspiration, compared to complete exhalation, in a small proportion of adults 3.
Related pathology
Abnormal dilatation of the pancreatic duct indicates obstruction of the normal flow of pancreatic secretions due to a distal (i.e. downstream) tumor or stricture. This can occur with acute pancreatitis, chronic pancreatitis or pancreatic neoplasms. Rarely, pancreatic duct dilatation can occur with tumoral hypersecretion of mucin (e.g. from intraductal papillary mucinous neoplasms).
Some authors suggest a main pancreatic duct dilatation (≥2.5 mm) without an obvious cause as an independent predictor of developing pancreatic cancer 6.
References
- 1. Hadidi A. Pancreatic duct diameter: sonographic measurement in normal subjects. J Clin Ultrasound. 1983;11 (1): 17-22. Pubmed citation
- 2. Sirli R, Sporea I. Ultrasound examination of the normal pancreas. Med Ultrason. 2011;12 (1): 62-5. Pubmed citation
- 3. Wachsberg RH. Respiratory variation of the diameter of the pancreatic duct on sonography. AJR Am J Roentgenol. 2000;175 (5): 1459-61. doi:10.2214/ajr.175.5.1751459 - Pubmed citation
- 4. Chao HC, Lin SJ, Kong MS et-al. Sonographic evaluation of the pancreatic duct in normal children and children with pancreatitis. J Ultrasound Med. 2001;19 (11): 757-63. Pubmed citation
- 5. Glaser J, Högemann B, Krummenerl T et-al. Sonographic imaging of the pancreatic duct. New diagnostic possibilities using secretin stimulation. Dig. Dis. Sci. 1987;32 (10): 1075-81. Pubmed citation
- 6. Tanaka S, Nakao M, Ioka T et-al. Slight dilatation of the main pancreatic duct and presence of pancreatic cysts as predictive signs of pancreatic cancer: a prospective study. Radiology. 2010;254 (3): 965-72. Radiology (full text) - doi:10.1148/radiol.09090992 - Pubmed citation
- 7. Tanaka S, Nakaizumi A, Ioka T et-al. Main pancreatic duct dilatation: a sign of high risk for pancreatic cancer. Jpn. J. Clin. Oncol. 2002;32 (10): 407-11. Jpn. J. Clin. Oncol. (full text) - doi:10.1093/jjco/hyf093 - Pubmed citation
- 8. Mortelé KJ, Rocha TC, Streeter JL et-al. Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics. 2006;26 (3): 715-31. doi:10.1148/rg.263055164 - Pubmed citation
- 9. Edge MD, Hoteit M, Patel AP, Wang X, Baumgarten DA, Cai Q. Clinical significance of main pancreatic duct dilation on computed tomography: single and double duct dilation. (2007) World journal of gastroenterology. 13 (11): 1701-5. doi:10.3748/wjg.v13.i11.1701 - Pubmed
- 10. Se Woo Kim, Se Hyung Kim, Dong Ho Lee, Sang Min Lee, Yeon Soo Kim, Jin Young Jang, Joon Koo Han. Isolated Main Pancreatic Duct Dilatation: CT Differentiation Between Benign and Malignant Causes. (2017) American Journal of Roentgenology. doi:10.2214/AJR.17.17963
- 11. Del Chiaro M, Torphy R, Schulick R. Pancreatic Incidentalomas: Investigation and Management. J Intern Med. 2021;290(5):969-79. doi:10.1111/joim.13359
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