MRCP in a 30-year-old woman with recurrent attacks of acute pancreatitis shows the main pancreatic duct draining through the minor papilla, appearing to cross the expected course of the common bile duct, while a short ventral duct drains separately through the major papilla. No ductal communication between the two systems is seen. This appearance is diagnostic of:

• A Annular pancreas
• B Agenesis of the dorsal pancreas
• C Anomalous pancreaticobiliary junction
• D Pancreas divisum ✓

Explanation

Pancreas divisum results from failure of fusion of the dorsal and ventral pancreatic ducts during embryogenesis, so the dominant dorsal duct drains through the minor papilla while the short ventral duct drains with the common bile duct through the major papilla. On MRCP the dorsal duct crosses the common bile duct and the two systems do not communicate. Annular pancreas encircles the duodenum, and anomalous pancreaticobiliary junction means a long common channel outside the duodenum.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.