Findings:
1.????? Separate opening of the pancreatic duct at the minor papilla ? pancreatic duct is seen to course medial to the common bile duct
2.????? The lower pole calyces of both kidneys are seen to point medially ? IVP equivalent of Horseshoe Kidney on MRCP.
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Answer:
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1.????? Pancreatic divisum
2.????? Horseshoe Kidneys
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Discussion: Pancreatic Divisum? - the diagnostic finding is demonstrating separate opening of the major pancreatic duct (PD) separate from the CBD. PD is seen to course medial and superior to the CBD opening.
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Typical finding of horseshoe kidneys on IVP is demonstrating abnormal orientation of the lower pole calyces. These calyces are medially oriented due to lower pole fusion.
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References:
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1.????? Manfreddi R, Costamagna G et al.? Pancreas Divisum and ?Santorinicele?: Diagnosis with Dynamic MR Cholangiopancreatography with Secretin Stimulation.? November 2000 Radiology, 217, 403-408
2.????? Leyendecker J R, Barnes C E, Zagoria R J. MR Urography : Technique and Clinical applications. January 2008 RadioGraphics, 28, 23-46
?Contribution: Dr Paresh Desai, Apollo Victor Hospital, Goa?