Case 2

This is an MRCP study, showing dilatation of the dorsal pancreatic duct of Santorini; at the proximal end of this duct, there are three round filling defects representing stones. This duct drains into the minor duodenal papilla.

The shorter and less prominent ventral pancreatic duct of Wirsung is not dilated, and joins the CBD to drain at the major duodenal papilla.

I cannot appreciate any communication between the two ducts on this MRCP study.

The features are in keeping with pancreatic divisum, complicated by formation of pancreatic stones in the dorsal duct of Santorini and resultant ductal obstruction.

I would communicate the findings to the referring physician and recommend discussion at hepatobiliary MDT.