Ansa pancreatica: a rare cause of acute recurrent episode in chronic pancreatitis

Ansa pancreatica is a rare anatomic variation of pancreatic ducts. It is a predisposing factor of recurrent pancreatitis. In this case report, we describe a case of a 24-year-old male suffering from an ansa pancreatica with a non-patent major papilla, diagnosed on magnetic resonance cholangiopancreatography (MRCP). The ansa pancreatica was revealed by an episode of acute pancreatitis attacks in chronic pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed important abrupt dilation in the main pancreatic duct with an ansa loop in the pancreatic duct in the head of the pancreas, and a sphincterotomy of the minor papilla was performed. The procedure was difficult and the placement of a long-term pancreatic stent during the ERCP was impossible, thus a surgical pancreatico-jejunostomy was proposed as a treatment of an ansa pancreatica with a non-patent major papilla.