Ansa pancreatica identified on magnetic resonance cholangiopancreatography: a case report

A young female presented with acute epigastric pain radiating to the back, with associated symptoms of vomiting and a 2-year history of similar intermittent upper abdominal symptoms with no alcohol use history, smoking, or chronic illness. Laboratory investigations revealed elevated serum amylase and lipase, while imaging studies demonstrated acute-on-chronic pancreatitis with a dilated main pancreatic duct. Magnetic resonance cholangiopancreatography revealed a ductal anomaly, ansa pancreatica, characterized by a looping communication between the main and accessory pancreatic ducts draining via the minor papilla. Conservative management of symptoms continued to fail; therefore, a surgical procedure, Frey's procedure, was performed, which showed improved clinical outcomes. This case highlights the clinical significance of ansa pancreatica as a rare but often misdiagnosed cause of recurrent pancreatitis in young patients without an alcohol use history.