Chronic pancreatitis with pancreatic duct stones

Case contributed by Dr Heba Abdelmonem

Presentation

History of chronic pancreatitis presented with abdominal pain and vomiting.

Patient Data

Age: 30-35 years
Gender: Male

Distended GB with multiple signal void stones the largest 15 mm.

Well delineated CBD with a 10 mm diameter. No evidence of intraluminal stones. No evidence of dilated intrahepatic biliary radicles.

Atrophic for age pancreatic parenchyma with multiple small scattered signal voids mostly calcification.

The main pancreatic duct is tortuous and dilated throughout its course with a beaded appearance reaching up to 14 mm in diameter. Multiple intraductal calculi are present, the largest measuring 10 mm seated obstructing the pancreatic duct opening. 

A small high T2 signal focal seated within the hepatic dome.

Case Discussion

Pancreatic ductal calculi are limited and most often associated with chronic pancreatitis. Our patient gave a history of pancreatitis and presented with abdominal pain. An ultrasound was done shows multiple gallbladder calculi as well as a dilated pancreatic duct. MRCP was requested revealing the presence of multiple pancreatic duct calculi. Generally speaking, the presence of parenchymal calcification, intraductal stones, and parenchymal atrophy is almost specific for chronic pancreatitis.
 

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Case information

rID: 73793
Published: 23rd Jan 2020
Last edited: 24th Jan 2020
Inclusion in quiz mode: Included
Institution: Zagazig University Hospital