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What Does My MRCP Report Indicate When Diagnosed With Evolving Chronic Pancreatitis?
Question: Hello doctor
I was diagnosed with "Evolving chronic pancreatitis" last year based on EUS symptoms like Hyperechoic foci, strands and lobulations, cyst , and dialated pancreatic duct of 3mm in body region. There was no pain or calcification or stone or strictures. i was also bit diabetic. Now after 1 year i started having having oily stools after oily food one day. this process continued for few days and i started getting oily stools on and off after some oily or heavy food. My doctor given me pancreatitic enzymes creon. I have also lost 2 kg weight in last 2 months. MY gall bladder was also removed last year.
I have gone through MRCP today and report of MRCP is as below :-
DEPARTMENT OF RADIODIAGNOSIS AND IMAGING
Patient Name
: XXXXXXX DUA
Procedure Date
: 12/09/2015
UHID
: JHN0000
Order From
: RADIOLOGY-BILL-GF-AB
Age/Sex
: 35Y/M
Accession No.
: SC115MR0000
Requested By
: DR. XXXXXXX BHALLA
Investigation
: MRCP
Ordered Time
: 12/09/2015
Reported Time
: 12-9-2015 10:43:49
MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY
PROCEDURE
MRCP was performed on 3 Tesla scanner using heavily T2 weighted sequences in coronal and oblique coronal planes. T1 as well as T2 weighted images were also obtained through the liver and pancreas.
Clinical details- Status post Cholecystectomy on ATT for periportal lymph nodes. Previous history of acute pancreatitis.
FINDINGS
Liver is normal in size and shows normal signal intensity. No focal lesion seen. The intrahepatic biliary radicals are not dilated. No SOL. Hepatic vein and portal vein seen normal.
Gall bladder is not visualised (operated).
Pancreas is atrophic with irregular dilated pancreatic duct with dilated ductules. There is a well defined cyst measuring 2.4 x 1.9 cm in pancreatic head – communicating with pancreatic duct.
Two other cysts measuring 2.6 x 1.8 & 1.5 x 1.1 cm are seen anterosuperior to pancreatic body partially within the pancreatic parenchyma. The cysts are not communicating with the pancreatic duct.
Portal & splenic veins are normal. Flow void of splenic artery is normal.
There are multiple periportal & Peripancreatic lymph nodes, largest measuring 2.3 x 1.8 cm.
MRCP-
Intrahepatic biliary radicals are normal.
CBD is normal in course and calibre ( 6.3 mm ). No intraluminal signal void/calculus in CBD.
IMPRESSION: 1. Chronic pancreatitis with pseudocysts
2. Multiple periportal & Peripancreatic lymph nodes.
Dr. XXXXXXX Garg
MD,DNB
Sr. Consultant - Radiology
Note: (1) This report is NOT valid for medico-legal purposes.
(2) In case of any discrepancy due to machine error or typing error, please get it rectified immediately.
I was diagnosed with "Evolving chronic pancreatitis" last year based on EUS symptoms like Hyperechoic foci, strands and lobulations, cyst , and dialated pancreatic duct of 3mm in body region. There was no pain or calcification or stone or strictures. i was also bit diabetic. Now after 1 year i started having having oily stools after oily food one day. this process continued for few days and i started getting oily stools on and off after some oily or heavy food. My doctor given me pancreatitic enzymes creon. I have also lost 2 kg weight in last 2 months. MY gall bladder was also removed last year.
I have gone through MRCP today and report of MRCP is as below :-
DEPARTMENT OF RADIODIAGNOSIS AND IMAGING
Patient Name
: XXXXXXX DUA
Procedure Date
: 12/09/2015
UHID
: JHN0000
Order From
: RADIOLOGY-BILL-GF-AB
Age/Sex
: 35Y/M
Accession No.
: SC115MR0000
Requested By
: DR. XXXXXXX BHALLA
Investigation
: MRCP
Ordered Time
: 12/09/2015
Reported Time
: 12-9-2015 10:43:49
MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY
PROCEDURE
MRCP was performed on 3 Tesla scanner using heavily T2 weighted sequences in coronal and oblique coronal planes. T1 as well as T2 weighted images were also obtained through the liver and pancreas.
Clinical details- Status post Cholecystectomy on ATT for periportal lymph nodes. Previous history of acute pancreatitis.
FINDINGS
Liver is normal in size and shows normal signal intensity. No focal lesion seen. The intrahepatic biliary radicals are not dilated. No SOL. Hepatic vein and portal vein seen normal.
Gall bladder is not visualised (operated).
Pancreas is atrophic with irregular dilated pancreatic duct with dilated ductules. There is a well defined cyst measuring 2.4 x 1.9 cm in pancreatic head – communicating with pancreatic duct.
Two other cysts measuring 2.6 x 1.8 & 1.5 x 1.1 cm are seen anterosuperior to pancreatic body partially within the pancreatic parenchyma. The cysts are not communicating with the pancreatic duct.
Portal & splenic veins are normal. Flow void of splenic artery is normal.
There are multiple periportal & Peripancreatic lymph nodes, largest measuring 2.3 x 1.8 cm.
MRCP-
Intrahepatic biliary radicals are normal.
CBD is normal in course and calibre ( 6.3 mm ). No intraluminal signal void/calculus in CBD.
IMPRESSION: 1. Chronic pancreatitis with pseudocysts
2. Multiple periportal & Peripancreatic lymph nodes.
Dr. XXXXXXX Garg
MD,DNB
Sr. Consultant - Radiology
Note: (1) This report is NOT valid for medico-legal purposes.
(2) In case of any discrepancy due to machine error or typing error, please get it rectified immediately.
Brief Answer:
Chronic pancreatitis- probably Unknown cause
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
You are having chronic pancreatitis as evident by the features seen in EUS and your symptoms like oily stools.
Your pancreas has damaged significantly as evident by high blood sugar.
There are umpteen number of causes for chronic pancreatitis like alcohol intake, genetic, metabolic, autoimmune, obstructive. In about 30% of the causes it is idopathic which means the cause is not known.
There is no specific diagnostic tests for all causes except a few.
Lipid profile, serum IgG4, genetic markers, tests for hyperparathyroidism may be done which are for some of the causes.
If these are inconclusive, then you probably have idiopathic pancreatitis which means cause is not known.
I hope that answers your query.
Let me know if you have any more questions.
Regards,
Dr.R.K.
Chronic pancreatitis- probably Unknown cause
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
You are having chronic pancreatitis as evident by the features seen in EUS and your symptoms like oily stools.
Your pancreas has damaged significantly as evident by high blood sugar.
There are umpteen number of causes for chronic pancreatitis like alcohol intake, genetic, metabolic, autoimmune, obstructive. In about 30% of the causes it is idopathic which means the cause is not known.
There is no specific diagnostic tests for all causes except a few.
Lipid profile, serum IgG4, genetic markers, tests for hyperparathyroidism may be done which are for some of the causes.
If these are inconclusive, then you probably have idiopathic pancreatitis which means cause is not known.
I hope that answers your query.
Let me know if you have any more questions.
Regards,
Dr.R.K.
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr. How to follow further on this. Is their any treatment to solve this. Kindly see my mrcp report also. Does both are giving same findings. And pls also let me know what is the progonis of this. Will this be calcified in future and cause lot of pain. Additionally if I will keep taking digestive enzymes and restricted oily food can I avoid calcification in future.
Brief Answer:
Answer given below
Detailed Answer:
Hi,
Pancreas has two functions - exocrine and endocrine.
Both are affected in your case.
For exocrine deficiency you need to continue taking Creon.
For endocrine deficiency you may have to be on insulin. Confirm the deficiency by checking blood glucose again.
I saw both the reports and both tell the same.
Fortunate that you are not having pain. Difficult to say whether you develop pain in the future.Enzymes provide relief from digestive problems and does not do anything for the disease process.
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
Pancreas has two functions - exocrine and endocrine.
Both are affected in your case.
For exocrine deficiency you need to continue taking Creon.
For endocrine deficiency you may have to be on insulin. Confirm the deficiency by checking blood glucose again.
I saw both the reports and both tell the same.
Fortunate that you are not having pain. Difficult to say whether you develop pain in the future.Enzymes provide relief from digestive problems and does not do anything for the disease process.
Regards,
Dr.R.K.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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