Anatomical Variations of the Pancreatic Ductal System on MRCP: Clinical Implications and Correlation with Pancreatitis

Abstract

Introduction: The pancreatic ductal system (PDS), comprising the main pancreatic duct (MPD) and the accessory pancreatic duct (APD), exhibits considerable anatomical variation. Certain ductal anomalies such as pancreas divisum and ansa pancreatica are known to be associated with recurrent or idiopathic pancreatitis. Magnetic resonance cholangio pancreatography (MRCP) offers a non-invasive means to evaluate these configurations. This study aimed to analyse the ductal patterns of the pancreas using MRCP and to assess their clinical significance.
Materials and Methods: This observational cross-sectional study was conducted on 12 adult patients who underwent MRCP for evaluation of pancreaticobiliary anatomy. Patients with previous pancreatic surgery, poor-quality images, or known malignancy were excluded. Ductal configurations were categorized as normal or variant types (e.g., pancreas divisum, ansa pancreatica, ductal duplication, absent APD). Clinical correlations were noted.
Results: The most common configuration was normal MPD-APD fusion (Type I), seen in 7 patients (58.3%). Pancreas divisum was observed in 2 patients (16.7%), one of whom had chronic abdominal pain. Ansa pancreatica was noted in 1 patient (8.3%) with a history of acute pancreatitis. Less common variants included absent APD and ductal duplication (each in 1 patient, 8.3%). Most other variants were asymptomatic.
Conclusion: Normal ductal anatomy was most common, but clinically significant variants such as pancreas divisum and ansa pancreatica were also identified. MRCP is an effective non-invasive tool for detecting ductal anomalies, and recognizing these variants is essential in evaluating patients with unexplained pancreatitis or before pancreatic
interventions.

How to cite this article:
Kumar P, Yadav A, Garg S, Gupta S. Anatomical
Variations of the Pancreatic Ductal System on
MRCP: Clinical Implications and Correlation
with Pancreatitis. J Adv Res Med Sci Tech.
2025;12(3&4):1-5.

DOI: https://doi.org/10.24321/2394.6539.202505