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RADIOLOGY: PANCREAS: Case# 49: CHRONIC PANCREATITIS, LARGE DUCT STONES. 48 year old woman with long history of abdominal pain which is now worsening. There is a small amount of focal fatty infiltration in the left lobe of the liver adjacent to the falciform ligament. There is mild central biliary dilatation and the common hepatic duct is prominent. There is calcification seen throughout the pancreas. The pancreatic duct is dilated and measures approximately 12mm in the region of the head and neck. There appear to be large stones present within the dilated duct. There is also a 2cm x 2cm fluid filled lesion in the pancreatic head likely represents a pseudocyst, but may communicate with the duct. There are no inflammatory changes seen to suggest acute pancreatitis. Most cases of chronic pancreatitis are the result of prolonged alcohol abuse. Other causes include hyperlipidemia, hyperparathyroidism, cystic fibrosis and cholelithiasis. Hereditary, or familial, pancreatitis is chronic pancreatitis without obvious etiology. CT findings in chronic pancreatitis include: dilatation of main pancreatic duct (66%), parenchymal atrophy (54%), pancreatic calcifications (50%), pseudocysts (34%), focal pancreatic enlargement (32%), biliary ductal dilatation (29%), and peripancreatic fat abnormalities (16%).

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