Acute pancreatitis secondary to stone at minor papilla and pancreatic divisum
Presentation
Acute onset abdominal pain and elevated serum lipase.
Patient Data
CT Abdomen
The pancreas is edematous and enlarged with peri-pancreatic fat stranding. No obvious foci of necrosis. Acute peri-pancreatic fluid collection in lesser sac.
The pancreatic duct is prominent measuring up to 4 mm. CBD prominent measuring up to 7 mm. Main pancreatic duct appears to drain via the minor papilla suggesting pancreatic divisum. A small rounded calcific focus at minor papilla in keeping with a stone.
The gall bladder is normal. No cholelithiasis or features of cholecystitis.
Ascites and regional inflammatory changes also present.
Incidental finding of median arcuate ligament syndrome.
Case Discussion
Anatomic variants can predispose to pathology due to altered anatomy and relationships with other structures.
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