Intraductal papillary mucinous neoplasm
Initially presented with acute pancreatitis, follow up MRI 6 years post initial presentation.
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There is generalised pancreatic parenchymal atrophy with mild dilatation of the main and accessory pancreatic ducts.
There is significant dilatation of the uncinate process pancreatic duct which is seen extending into the main pancreatic duct.
At ERCP a fish-mouthed, open ampulla was demonstrated to exude mucinous content. Thought to be main duct rather then side branch due to the main duct dilatation. Subsequently categorised as having a higher underlying potential for malignancy. Patient regarded as potentially requiring a pancreatectomy with 12 monthly follow up until a change occurs.