Dilated Pancreatic Duct

A dilated pancreatic duct can be diagnosed on imaging tests like ultrasound, CT and MRI.  The function of the pancreatic duct is to carry digestive enzymes from the pancreas to the intestine.  A dilated pancreatic duct may indicate serious abnormalities like pancreatitis or tumor.   A dilated pancreatic duct can also indicate a higher risk of developing a tumor of the pancreas in the future.

What is a dilated pancreatic duct?

Some radiologists will use their experience to say whether a pancreatic duct is dilated.  The pancreatic duct can also be measured and determined to be dilated.  The pancreatic duct can be dilated throughout its course in the pancreas or in a smaller segment.

Dilated pancreatic duct symptoms

A dilated pancreatic duct may have no symptoms.  Abdominal pain is a common symptom when it is associated with pancreatitis  and tumors.

How is a dilated pancreatic duct diagnosed?

A dilated pancreatic duct can be diagnosed on imaging tests like ultrasound, CT and MRI.  An MRI focused on the pancreatic and bile ducts is called an MRCP and is the best non invasive test to evaluate the pancreatic duct.

X-rays do not show the pancreas and the pancreatic duct.  These structures blend in with the other soft tissues of the abdomen and can not be seen.

Dilated pancreatic duct on imaging

Dilated pancreatic duct is best imaged with a focused MRI called an MRCP.  This test best shows the ducts and provides the most detail.  Other tests can also show a dilated pancreatic duct but may not give us as much information.

Dilated pancreatic duct on CT

A CT scan will often show us a dilated pancreatic duct but may not show us the reason for the dilation as well as an MRI.

Dilated pancreatic duct on Ultrasound

An an ultrasound of the pancreas will often show us a dilated pancreatic duct but may not show us the reason for the dilation as well as an MRI.

Dilated pancreatic duct on MRI

A focused MRI of the pancreatic duct called an MRCP will show us the duct and provide the most detail.  The test also gives us a detailed look at the pancreas and surrounding structures.

What else can look like dilated pancreatic duct in radiology?

A blood vessel that crosses the pancreas can sometimes mimic a dilated duct but is rarely confused.  A cystic lesion of the pancreas can mimic a focally dilated duct.

What causes a dilated pancreatic duct?

Dilated pancreatic duct can be caused by chronic pancreatitis.  Chronic pancreatitis is a result of chronic inflammation and scarring of the pancreas.  Chronic alcohol abuse is a common cause.  The pancreatic duct will be dilated and beaded as the disease progresses.  The pancreas will often have calcifications.

Pancreatic tumors and masses that originate from or obstruct the duct will cause dilation of the pancreatic duct.  Rarely a tumor of the duct which secretes mucin can cause it to appear dilated (intraductal papillary mucinous neoplasm).

Stones or strictures (narrowing) can also cause cause dilation of the pancreatic duct upstream from the obstruction.

Sometimes replacement of the pancreas with fat and aging can cause the duct to be more dilated.

Is a dilated pancreatic duct cancerous?

It can be in some cases. Further imaging with MRI can help look for a tumor.  An invasive test called an endoscopic ultrasound can take a close look at the pancreas for tumor.

Some studies have shown that a dilated pancreatic duct can be a risk factor for future development of a tumor.

What type of doctor treats a dilated pancreatic duct?

A specially trained gastroenterologist in hepatobiliary disease and interventions would be the best suited to treat a dilated pancreatic duct and any associated conditions.  Surgeons may be involved if a neoplasm needs to be resected.  Oncologists may be involved if there is a cancer that needs medical treatment.

Dilated pancreatic duct treatment

The treatment will depend on the cause.  A tumor may need to be surgically removed.  A pancreatic cancer may need both surgical and chemotherapy treatment.  A dilated pancreatic duct alone may just need close imaging follow up.

Dilated pancreatic duct: summary

Dilated pancreatic duct is diagnosed on ultrasound, CT and MRI.  A focused MRI called an MRCP is the best non invasive test to look at the pancreatic duct and any associated abnormalities of the pancreas.

A dilated pancreatic duct is most commonly caused by chronic pancreatitis and tumors.  Sometimes we can not find a cause for the dilated pancreatic duct.  In these cases, more invasive testing and future imaging follow up may be needed.

A specially trained interventional gastroenterologist is best qualified to manage and treat diseases of the pancreatic duct.  Treatment and follow up will be directed to the underlying cause.  Other specialists like surgeons and oncologists may be involved in some cases.