A 21-year-old woman presents with right upper quadrant pain and cholestatic liver function tests. MRCP demonstrates two large calculi (GS, Figure 1) in the gallbladder.

Incidental note is made of the unusual pancreatic duct anatomy. The fusion of the dorsal and ventral pancreatic ducts during development usually results in the main pancreatic duct of Wirsung draining via the major duodenal papilla with the common bile duct (CBD). Variations in this arrangement occur and may predispose to pancreatitis.

Figure 2 demonstrates the ventral duct joining the dorsal duct (PD), which then drains into the minor duodenal papilla proximal to the CBD.