Intraductal papillary mucinous neoplasm - main duct type

Discussion:

This case represents dilated pancreatic ducts and common bile duct with mild pneumobilia and no associated signs of pancreatitis. No signs of distal biliary obstruction with a hyperdense stone or pancreatic head / ampullary mass lesion.

These features are reflecting biliary obstruction at the level of the duodenal ampulla. Intraductal papillary mucinous neoplasms or tumors (IPMN) could be considered. Further assessment to confirm the diagnosis is needed by ERCP or MRCP. Main duct type carries a risk of malignant transformation.

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