case_images: PMC11228964_01
case_images: MRI evaluation in family members with PRSS1 mutation. (A) Reported case: Ectasia of the main biliary branches (8 mm). Duplication of the main pancreatic duct that appears dilated and irregular. A stenosis (from 9 to 6 mm) is shown in the first portion of the duct. The pancreatic parenchyma has reduced thickness and altered signal. (B) Older brother: The main pancreatic duct is serpiginous and dilated up to a maximum caliber of 5 mm. The pancreatic parenchyma has reduced thickness and altered signal. (C) Mother: The pancreatic duct is single and of normal caliber. The pancreatic parenchyma is significantly reduced.
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case_images: PMC11228964_01_fped-12-1393891-g002.jpg
case_images: F2
case_images: Coronal MIP reformation from the magnetic resonance cholangiopancreatography (MRCP) sequence shows duplication of the main pancreatic duct (arrow). The gallbladder is distended by biliary sludge.
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case_images: PMC11228964_01_fped-12-1393891-g003.jpg
case_images: F3
case_images: The cholangio-MRI confirmed the presence of an irregular and dilatated main pancreatic duct (Figure 3).
case_images: Coronal and axial T2 weighted MRI sequences performed for abdominal pain, vomiting, and loose stool demonstrates a 7 mm intraductal papillary stone (arrowhead) causing severe upstream dilatation of the biliary and pancreatic ducts, especially the lower duplicated segment of the main pancreatic duct (arrows).
case_images: fped-12-1393891-g004.jpg
case_images: PMC11228964_01_fped-12-1393891-g004.jpg
case_images: F4
case_images: In addition to further enlargement of the gallbladder and the pancreatic and biliary ducts (up to 11 mm of maximum caliber), the imaging revealed signs of acute cholecystitis and a 7 mm calculus located in the main pancreatic duct at the level of the duodenal papilla (Figure 4).
case_images: Coronal MIP reformation from MRCP performed after cholecystectomy and pancreatic duct drainage shows the stent in the main pancreatic duct (arrowhead) and persistent dilatation of the biliary and pancreatic ducts.
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case_images: PMC11228964_01_fped-12-1393891-g005.jpg
case_images: F5
case_images: After 20 months, he underwent an MRI that showed ectasia of the extrahepatic biliary tract and irregularity of the pancreatic duct caliber with hypointense images (Figure 5).