Presentation
Current history of epigastric pain. Previous history of recurrent attacks of upper abdominal pain.
Patient Data
There is marked non-uniform dilatation of the main pancreatic duct with areas of narrowing along its course in the body and tail. The duct part at the pancreatic head shows multiple signal void areas that proved to be calculi and calcification by CT.
There is also fusiform dilatation of the left hepatic duct, main hepatic duct and to a lesser extent common bile duct with intervening areas of narrowing.
The gallbladder shows distal segmental wall thickening and multiple intramural fluid-filled cystic spaces keeping with adenomyomatosis.
There is dilatation of the pancreatic duct with multiple stones seen mainly in the region of the pancreatic head.
Case Discussion
Pancreatic duct stones are thought to be associated with chronic pancreatitis, pancreatic duct fibrosis, malnutrition, alcohol abuse and spontaneous pancreatic duct stone. These conditions cause pancreatic exocrine dysfunction and intraductal proteinaceous deposits which subsequently lead to calcification, thus inducing chronic pancreatitis and pancreatic duct stone formation.
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