Multimodality Imaging of Pancreatic and Biliary Congenital Anomalies

Abstract

A wide spectrum of anomalies of the pancreas, the pancreatic ductal system, and the biliary tree are commonly encountered at radiologic evaluation. These anomalies may simulate various neoplastic, inflammatory, and posttraumatic conditions and should be part of the differential diagnosis for a variety of abnormalities found at diagnostic imaging. Anatomic variants, developmental anomalies (eg, pancreas divisum, annular pancreas, ectopic pancreas, pancreatic agenesis and hypoplasia), and congenital diseases (congenital pancreatic cysts, von Hippel-Lindau disease, choledochal cysts), in addition to potential imaging pitfalls (uneven distribution of fat, "pseudomasses"), can all pose a diagnostic challenge for the radiologist. Familiarity with these anomalies, the imaging techniques available for their study, and their variable imaging manifestations is necessary for differentiating them from other biliary and pancreatic conditions. A basic understanding of the embryologic development and normal anatomy of the pancreas and biliary tree is also essential for identifying these anomalies.

Biliary and Pancreatic Dysgenesis in Mice Harboring a Mutation in Pkhd1

“…37 The intra-and extrahepatic bile ducts and the pancreatic ducts descend from the same progenitor. 38,39 The commonality of the fibrocystin-dependent phenotype we find in these tissues suggests that fibrocystin functions correspondingly in all three tissues of common embryonic origin.…”

Dorsal pancreas agenesis associated with unfused crossed renal ectopia- a rarest of the rare anomalies

“…The body and uncinate process develops from ventral pancreatic bud. The body and tail develops from dorsal bud (Mortele et al, 2006). At 7th week of gestational life, the ventral bud rotates around the duodenum to attain posterior relation to the dorsal bud.…”

“…The anomaly is asymptomatic in most of the patient; however it can be present with nonspecific symptoms such as abdominal pain and acute or chronic pancreatitis. Sometimes it can present with features of diabetes mellitus due to absence of islet cell in pancreas tail agenesis (Mortele et al, 2006). Renal anomaly can be positional or fusion anomalies.…”

MR cholangiopancreatography at 3.0 T in children: diagnostic quality and ability in assessment of common paediatric pancreatobiliary pathology

“…Some authors are of the view that, in a long common channel, hypertrophy and spasticity of the sphincter choledochus inferior resulting in increased pressure in the bile duct rather than reflux of pancreatic juices results in the formation of a choledochal cyst [15]. A common pancreaticobiliary channel of .15 mm in length is considered to be abnormal in adults [16]. However, there are limited data on the normal length of the common channel in children, with only one recent study using 5 mm as a cut-off value [17].…”