The efficacy of magnetic resonance cholangiopancreatography in assessing the etiology of acute idiopathic pancreatitis

Aims: Idiopathic pancreatitis may be diagnosed once all causes of pancreatitis are excluded by thorough history, metabolic profile and conventional imaging modality, i.e., abdominal ultrasonography. In this study, we have attempted to evaluate the cause of idiopathic pancreatitis with the help of magnetic resonance cholangiopancreatography (MRCP). Methods: Fifty patients presenting with idiopathic pancreatitis were assessed prospectively using MRCP with strength 1.5 Tesla for potential cause of the attack of pancreatitis. Results: Magnetic resonance cholangiopancreatography was able to establish the cause of pancreatitis in eleven (22%) patients, as follows. Common bile duct stone in one (2%), pancreatic divisum in one (2%), gallbladder stone in one (2%), pancreatic duct stone in one (2%), chronic pancreatitis in two (4%), gallbladder sludge in two (4%) and anomalous pancreaticobiliary union in three (6%) patients. Conclusion: Magnetic resonance cholangiopancreatography, a non- invasive and complication free imaging modality is able to establish the cause of acute pancreatitis in patients in whom the diagnosis of idiopathic pancreatitis has been made following standard investigations. Idiopathic pancreatitis should not be diagnosed unless MRCP has been performed.