Presentation
Recurrent epigastric pain and elevated pancreatic enzyme.
Patient Data
The second part of the duodenum shows intraluminal sac filled with contrast and gas causing focal expansion of that part.
MRCP was advised for better evaluation of the pancreas and biliary tree.
No signs of the annular pancreas or pancreatic divisum.
Case Discussion
Recurrent attack of epigastric pain with elevated pancreatic enzymes in this age group raises the concern of congenital anomaly. Both CT and the MRI illustrate an intraluminal membrane at the second portion of the duodenum, which gives the appearance of an "intraluminal diverticulum".
The features are those of duodenal web. This condition is usually seen in barium studies as a diverticulum filled first then the rest of duodenum.
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