PMC6358577_01
Contrast-enhanced axial computed tomography (CT) imaging from 2004 (age 27) showing intraductal calculi (arrow head) and extensive coarse pancreatic parenchymal calcifications (arrows).
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F1
She was found to have intraductal calculi and extensive coarse pancreatic parenchymal calcifications (Figure 1).
Contrast-enhanced axial CT imaging from 2008 (age 32) showing punctate intraductal calculi (arrow head) and few punctate pancreatic parenchymal calcifications (arrow).
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F2
During a hospitalization at age 32 for worsening abdominal pain, remarkably, a computed tomography scan showed dramatically reduced pancreatic calcifications (Figure 2), as well as chronic splenic vein thrombosis with perigastric collaterals, but no other local complications.
Contrast-enhanced coronal MRCP imaging from 2012 (age 35) demonstrating an abrupt termination of the pancreatic neck, consistent with a pancreatic neck stricture (arrow), with associated mild pancreatic duct dilation (A marker).
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F3
At age 35, magnetic resonance cholangiopancreatography revealed a ductal stricture in the pancreatic neck (Figure 3) with associated mild pancreatic duct dilation to 5.2 mm, and she underwent stricture dilation and placement of a dorsal duct stent (5 French x 5 cm external pigtail stent).
Contrast-enhanced axial CT imaging from 2015 (age 38) demonstrating a 10-mm x 4-mm covered metal stent within distal common bile duct (arrow).
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F4
A 10-mm x 4-cm covered metal stent (Figure 4) was placed in the distal common bile duct, with successful resolution of the stricture documented at the time of stent removal 4 months later.
Contrast-enhanced axial CT imaging from 2016 (age 39) demonstrating scattered punctate pancreatic parenchymal calcifications (arrow) but no intraductal calculi.
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F5
Computed tomography at age 39 for continued pain showed continued interval improvement of the calcifications, including disappearance of intraductal calcifications (Figure 5).