Ansa Pancreatica Causing Recurrent Pancreatitis in an Adolescent
Presenter Status
Resident/Psychology Intern
Abstract Type
Case Report
Primary Mentor or Principal Investigator
Nadia Ibrahimi, MD
Presentation Type
Poster
Start Date
21-5-2026 12:00 PM
End Date
21-5-2026 1:00 PM
Abstract Text
Background:
Ansa pancreatica is a rare anatomic variant of the pancreatic ductal system characterized by a looping communication between the main pancreatic duct (duct of Wirsung) and the accessory duct. This configuration may predispose to impaired pancreatic drainage and recurrent pancreatitis [1,2]. While the general anatomic prevalence in adults has been estimated at approximately 0.3–1.0%, pathologic pediatric cases causing recurrent pancreatitis are exceedingly rare and likely compounded due to diagnostic challenges and subtle imaging findings [1–3].
Objective:
To describe a pediatric case of recurrent pancreatitis secondary to ansa pancreatica and highlight diagnostic considerations and therapeutic outcomes.
Methods:
We report the case of a 13-year-old female with a history of recurrent acute pancreatitis beginning at age 10. Evaluation included laboratory testing and serial cross-sectional imaging. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) were utilized to delineate pancreatic ductal anatomy and guide therapeutic intervention.
Results:
Initial imaging demonstrated pancreatic ductal dilation without a clear obstructive etiology. Subsequent MRCP raised suspicion for an anatomic ductal variant, and ERCP confirmed a looping configuration of the ventral pancreatic duct consistent with ansa pancreatica. Therapeutic ERCP was performed with pancreatic sphincterotomy and placement of a pancreatic duct stent. Following intervention, the patient experienced resolution of abdominal pain, nausea, and vomiting, with no further episodes of pancreatitis during follow-up and return to normal activities.
Conclusion:
Ansa pancreatica is a rare but clinically significant pancreatic ductal variant that should be considered in pediatric patients with unexplained recurrent pancreatitis. Advanced imaging and endoscopic evaluation are essential when standard studies are nondiagnostic. Early recognition and targeted endoscopic therapy may reduce recurrent disease and mitigate long-term complications such as chronic pancreatitis [2–4].
References:
-
Adibelli ZH, Adatepe M, Isayeva L, et al. Ansa pancreatica: prevalence and association with pancreatitis. Diagn Interv Radiol. 2014;20(3):226–230.
-
Matsumoto S, Mori H, Miyake H, et al. Ansa pancreatica: an anatomical variant of the pancreatic duct associated with idiopathic pancreatitis. J Gastroenterol. 2001;36(12):857–861.
-
Bukowski J, Czakó L, Gyökeres T, et al. Pancreatic ductal variations in recurrent acute pancreatitis: diagnostic and therapeutic implications. Pancreatology. 2024;24(1):1–8.
-
Testoni PA, Mariani A, Curioni S, et al. Pancreatic sphincterotomy in recurrent acute pancreatitis associated with ductal anomalies. Gastrointest Endosc. 2008;68(6):1088–1094.
Ansa Pancreatica Causing Recurrent Pancreatitis in an Adolescent
Background:
Ansa pancreatica is a rare anatomic variant of the pancreatic ductal system characterized by a looping communication between the main pancreatic duct (duct of Wirsung) and the accessory duct. This configuration may predispose to impaired pancreatic drainage and recurrent pancreatitis [1,2]. While the general anatomic prevalence in adults has been estimated at approximately 0.3–1.0%, pathologic pediatric cases causing recurrent pancreatitis are exceedingly rare and likely compounded due to diagnostic challenges and subtle imaging findings [1–3].
Objective:
To describe a pediatric case of recurrent pancreatitis secondary to ansa pancreatica and highlight diagnostic considerations and therapeutic outcomes.
Methods:
We report the case of a 13-year-old female with a history of recurrent acute pancreatitis beginning at age 10. Evaluation included laboratory testing and serial cross-sectional imaging. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) were utilized to delineate pancreatic ductal anatomy and guide therapeutic intervention.
Results:
Initial imaging demonstrated pancreatic ductal dilation without a clear obstructive etiology. Subsequent MRCP raised suspicion for an anatomic ductal variant, and ERCP confirmed a looping configuration of the ventral pancreatic duct consistent with ansa pancreatica. Therapeutic ERCP was performed with pancreatic sphincterotomy and placement of a pancreatic duct stent. Following intervention, the patient experienced resolution of abdominal pain, nausea, and vomiting, with no further episodes of pancreatitis during follow-up and return to normal activities.
Conclusion:
Ansa pancreatica is a rare but clinically significant pancreatic ductal variant that should be considered in pediatric patients with unexplained recurrent pancreatitis. Advanced imaging and endoscopic evaluation are essential when standard studies are nondiagnostic. Early recognition and targeted endoscopic therapy may reduce recurrent disease and mitigate long-term complications such as chronic pancreatitis [2–4].
References:
-
Adibelli ZH, Adatepe M, Isayeva L, et al. Ansa pancreatica: prevalence and association with pancreatitis. Diagn Interv Radiol. 2014;20(3):226–230.
-
Matsumoto S, Mori H, Miyake H, et al. Ansa pancreatica: an anatomical variant of the pancreatic duct associated with idiopathic pancreatitis. J Gastroenterol. 2001;36(12):857–861.
-
Bukowski J, Czakó L, Gyökeres T, et al. Pancreatic ductal variations in recurrent acute pancreatitis: diagnostic and therapeutic implications. Pancreatology. 2024;24(1):1–8.
-
Testoni PA, Mariani A, Curioni S, et al. Pancreatic sphincterotomy in recurrent acute pancreatitis associated with ductal anomalies. Gastrointest Endosc. 2008;68(6):1088–1094.
Comments
Full text not provided by primary author
Poster Board Number: 4