Abstract
A 65-year-old woman presented with new-onset insulin-dependent diabetes. A CT scan revealed a dilated main pancreatic duct (MPD) without a mass. EUS demonstrated a 16-mm MPD with nonshadowing intraductal filling defects. A pediatric colonoscope with an outer diameter of 11.7 mm (PCF-Q180A; Olympus Medical Systems, Center Valley, Pa) was advanced to the afferent limb of a Billroth II reconstruction where a patulous major papilla was seen. Just proximal to the major papilla, a large mass of mucin occupied much of the lumen, and papillary fronds were seen emanating from the minor papilla (A).
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