Pancreatic duct stones are commonly found in patients with chronic pancreatitis. Pancreatic duct stones can contribute to abdominal pain and loss of function of the pancreas.
Imaging tests can often diagnose pancreatic duct stones. Pancreatic ductal stones can be treated with endoscopic and surgical methods.
What is a pancreatic duct stone?
A pancreatic duct stone forms in the pancreatic duct. The pancreatic duct carries digestive enzymes to the intestine. The pancreatic duct is present throughout the pancreas.
Symptoms of pancreatic duct stones
Symptoms include upper abdominal pain. These are similar symptoms that we see with chronic pancreatitis. Diagnosing a stone therefore requires imaging tests.
How is a pancreatic duct stone diagnosed?
We can see pancreatic duct stones on X-rays, ultrasound, CT and MRI.
An MRI called an MRCP that is focused on the pancreatic duct is the best test for diagnosis. This is because we can see the pancreatic duct and the stone within it directly.
What does a pancreatic duct stone look like on MRI?
A dedicated MRI of the pancreatic duct can be done that will show the pancreatic duct to be dilated. We will see a dark stone in the duct. There can also be multiple stones in the duct. The stones can cause a blockage in the duct.
What else can look like pancreatic duct stone in radiology?
Calcifications in the pancreas can be from tumors. Tumors will form masses which we can see on ultrasound, CT and MRI. X-rays can only show the calcification but will not show the tumor.
Blood vessels around the pancreas can calcify. The calcifications will be along the blood vessel.
What causes pancreatic duct stones?
Patients with chronic pancreatitis and alcoholism will form stones as a result of pancreatic duct narrowing (strictures) and resulting stasis of digestive enzymes.
Alcoholism and chronic pancreatitis also causes an imbalance in the pancreatic juice components which predisposes to stone formation.
Is a pancreatic duct stone dangerous?
Pancreatic duct stones can cause worsening pain in patients with chronic pancreatitis. The stones are not dangerous otherwise.
What type of doctor treats pancreatic duct stone?
Endoscopic treatment is done by a specially trained gastroenterologist. Surgeons are involved in surgical treatment.
Pancreatic duct stones treatment
Treatment is aimed at removing the stones through endoscopic or surgical methods.
Medical treatment may include pain medications, low fat diet and supplementation of pancreatic enzymes. This can reduce symptoms but will not dissolve the stones.
Pancreatic duct stone: summary
Pancreatic duct stones are commonly found in patients with a history of alcoholism and chronic pancreatitis. Pancreatic duct stones are diagnosed on imaging studies. An MRI that is focused on the pancreatic duct (MRCP) is best for diagnosing stones in the pancreatic duct.
There are multiple endoscopic and surgical treatments aimed at removing the stones. Treatment of the stones will help with symptoms.