16-year-old male with history of acute on chronic pancreatitis.EXAMINATION: Pancreas MRI and MRCP without /with IV contrast and Secretin1/25/2016 ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. SPLEEN: Small splenule. The splenic vein is attenuated near the confluence, however it is patent.PANCREAS: No evidence of pancreatic divisum or annular pancreas.There is increased internal and peripancreatic T2 signal abnormality as well as diffuse parenchymal restricted diffusion compatible with acute pancreatitis.The pancreatic ductal anatomy is abnormal. There is a persistent duct of Santorini. The main pancreatic duct bifurcates at the level of the pancreatic head with one branch draining into the duct of Santorini and one branch draining into the duct of Wirsung which drain into the minor and major papillae, respectively. After secretin administration, the duct of Santorini and Wirsung dilate equally indicating similar drainage rates.At the level of the pancreatic head, there is a subcentimeter cystic lesion which communicates with the duct of Santorini (image 29 of series 401). No enhancement is appreciated on postcontrast imaging.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Acute pancreatitis.2. Abnormal pancreatic ductal anatomy as described above.3. Focal cystic lesion in the pancreatic head communicating with the accessory duct likely representing focal ductal dilatation secondary to stricture from chronic pancreatitis.4. Patent, but attenuated splenic vein near the confluence.