Enlarged Pancreatic Duct Symptoms: Dilated Pancreatic Duct Treatment

The pancreatic duct is the tube in the pancreas which carries the pancreatic juice and enzymes from the pancreas to the small intestine (in the duodenum). Pancreatic enzymes are useful in digestion of food. Before its entry into the second part of the duodenum, the pancreatic duct joins with the common bile duct at the point called ampulla of vater, after which they enter the duodenum.

The pancreatic duct just like the pancreas is very important, and it cannot be ignored at any stage. Any problem within the duct can cause acute pancreatitis, a dreaded condition with high rate of mortality.

Problems in the pancreatic duct can be due to compression, obstruction or enlargement (inflammation) of duct. Most common cause for enlargement of pancreatic duct is presence of gall stone in common bile duct.

Causes Of Enlarged Pancreatic Duct

The pancreatic duct extends transversely from left to right in the pancreas. It commences from the tail of the pancreas runs all through the body and head of pancreas before entering into the duodenum. Before entering in the small intestine it comes in contact with the common bile duct. The size of pancreatic duct near the duodenum is approximately that of an ordinary quill.

  • Gall stone: The most common cause for enlarged pancreatic duct is an obstruction in the duct caused due to a stone, especially the gall stone. The tiny gall stone gets lodged into the ampulla of vater, and blocks the flow of pancreatic juice and bile into the duodenum. Due to the block, the bile may leak in the pancreas leading to its inflammation known as pancreatitis.
  • Carcinoma: Another cause for enlargement is pancreatic duct carcinoma. It is one of the most common pancreatic cancer forms.
  • Obstruction of ampulla of vater: by intestinal worm ascaris lumbricoid can occur sometime. It is very rare but the cause cannot be ruled out.
  • Alcoholism:  can disrupt the pancreatic duct and enlarge them and eventually cause pancreatitis.

Symptoms Of Dilated Pancreatic Duct

The symptoms of enlargement are that of pancreatitis either acute or chronic.

  • Pain in the upper middle portion of abdomen often precipitated after a large meal.
  • Pain can also precipitate after a bout of alcoholic drink.
  • The pain is severe and persistent and radiates to the back.
  • Pain is worse on lying down, but there is partial relief by sitting or stooping forward.
  • Pain is often associated with vomiting and nausea.
  • Distension of abdomen.
  • Excessive perspiration.
  • Moderate fever.
  • Jaundice.
  • Rapid pulse.
  • Low blood pressure.
  • Bluish discoloration around the umbilicus or in the flanks indicates severe form of disease.
  • A mass may be felt in the upper abdomen representing a pseudocyst.

Enlarged Pancreatic Duct Treatment

Enlargement of the duct can be due to many causes. From the clinical examination if the doctor suspects pancreatitis as a cause. He may advice further tests to detect and confirm his diagnosis. It will also help to start necessary treatment.

Ultrasonogram, MRI and CT scanning are useful in detecting pancreatitis. They can also detect pancreatic stones.

Patient needs hospitalization and nothing is given by mouth in acute stage. Intravenous fluids are administered and a close watch on pulse and blood pressure is kept.

Treatment to widen the duct: in chronic pancreatitis there is pain due to narrowing of the duct and ampula of vater. This narrowing can block the secretion of the pancreas and inflame the duct as well as the pancreas. One way to widen the duct and the ampulla of vater is introducing a stent (tube) in the duct. The stent can reduce the pain and increase the flow reduced due to obstruction of the pancreatic stone. Inserting a stent in the duct has its limitation due to high risk in the procedure.

Pancreatic lithotripsy is another option to break the lodged stone in the enlarged pancreatic duct.

In most severe cases surgery may be the last option.

11 Comments

  1. DR said:

    My 38 yr old daughter had a sudden pancreatic attack. The doctor diagnosed it as enlarged pancreas about 2 weeks back. She still has problem eating food. She feels full even after eating minimal food. What foods should she eat for her condition as she needs protein intake? She does not like fish, eggs or pork?

    March 15, 2013
    Reply
    • PUP said:

      Soy, beans, lentils, whole grain bread also contains enough amount of protein. She should also eat iron, vitamin B rich food. Green leafy vegetables, kale, spinach, seaweed are rich source of iron and vitamins. Also anti-oxidants rich food such as tomatoes, cherries, squash, and blueberries can be eaten. However, she is recovery stage of acute pancreatitis, therefore you should always ask your doctor before making any changes in food.

      March 15, 2013
      Reply
  2. KV said:

    My reports state that I have fatty liver. There are no stones detected. I would like to know whether this is pancreatitis. I do not drink or smoke. I eat healthy foods and also exercise regularly. I experience pain while jogging and sometimes I am unable to do it. What is the diagnosis for my condition?

    September 13, 2013
    Reply
  3. SU said:

    I have been diagnosed of suffering from pancreatitis. But I have never had pain that usually is prevalent in people suffering from pancreatitis. The only symptom that is constant is diarrhea. So is it pancreatitis or something else?

    October 28, 2013
    Reply
    • PUP said:

      I need to have some more information. What are the tests that are done? Have you done serum amylase and serum lipase blood tests? Is CT scan or an MRI of pancreas done? They are useful in diagnosing the condition aside from clinical symptoms and examination.

      October 29, 2013
      Reply
  4. GW said:

    I had severe pancreatitis attack and was hospitalized for it about 6 years ago. Now I have severe burning pain on the left side going through my back. My ultrasound reports mentioned 2 hepatic cysts and a dilated pancreatic duct. I take certain medications like gravol but I get hot flashes. I also feel tingling sensation in my legs. Can you suggest medications and diet that needs to be followed?

    March 25, 2014
    Reply
    • PUP said:

      You have to consult your physician to rule out a pancreatic problem that may have erupted once again. Often pancreatitis pain radiates from front to back between the two shoulder blades. He may recommend certain blood tests such as serum amylase and serum lipase. Meanwhile till you consult your doctor, eat diet consisting more of liquid. Avoid fried and spicy food as much as possible. Stop alcohol intake if you are drinking alcohol. Regarding medication, follow your physician’s instructions. The tingling sensation in legs may not be connected with pancreatitis problem. It may be an individual problem in itself. Your doctor after examination may suggest vitamin B complex supplements as remedial measure for tingling. However, the first priority for these problems is to consult your physician.

      March 25, 2014
      Reply
  5. Sharon said:

    It was discovered early this month that I have an abnormal pancreatic duct that is dilated. I do not have any discomfort. I have done MRI, ultra sound and x-ray. Sometimes, I experience gas after a meal. I am concerned about my health. What is the treatment and diagnosis for my condition?

    April 23, 2014
    Reply
    • PUP said:

      To answer your question I need some more information. Did you have an attack of pancreatitis previously? Pancreatitis is inflammation of pancreas. Pancreatic duct often remains dilated due to chronic pancreatitis. Chronic inflammation of pancreas causes morphological changes in pancreas and pancreatic duct. You have to consult a gastroenterologist to rule out many other underlining causes.

      May 8, 2014
      Reply
  6. Stephanie said:

    I have dual denial pancreatic stenosis. They were unable to stent the duct and just cut out the scar tissue. I was hospitalized for 12 days due to ERCP causing pancreatitis. It has been three months since and I still have pain but all my CT scans are normal and blood work is also fine. Any thing different I should do?

    August 8, 2017
    Reply
  7. Terri said:

    I am in extreme serious trouble. Presented in the ER with Lowe’s stomach pain, transverse colon and descending colon pain with centralize pain on left side. Gallbladder removed years ago. CT scan showed enlarged pancreatic duct. They wanted to admit me, but the new ER doctor did not know what she was doing? My fever bounces up and down to as high as over 100°. I cannot pass gas or burp. Pain is off the charts. I cannot eat. G.I. doctor wants to schedule an ERCP and I believe that MPCP would be the safest way. I feel I should go back to the ER, but I need to go to a different hospital. Please suggest what should I do?

    February 3, 2018
    Reply

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