Pancreas divisum overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pancreatic divisum is a congenital anomaly in the anatomy of the ducts of the pancreas in which a single pancreatic duct is not formed, but rather remains as two distinct dorsal and ventral ducts. [1] [2]
Diagnosis
History and Symptoms
A majority of individuals born with pancreas divisum will never have symptoms for their entire life. In most cases, pancreas divisum is only detected during an autopsy of a person that is deceased. However, approximately 1% of those with pancreas divisum will develop symptoms during their lifetime. Symptoms commonly include abdominal pain, nausea and/or vomiting, and pancreatitis. A small number of individuals may develop chronic pancreatitis.
Other Imaging Findings
The most common and accurate way of diagnosing an individual with this anomaly is by an ERCP. This test can demonstrate the presence of two separately draining ducts within the pancreas.
Treatment
Surgery
Pancreas divisum in individuals with no symptoms do not need treatment. Treatment of those with symptoms varies and has not been very well established. A surgeon may attempt a sphincterotomy by cutting the minor papilla to enlarge the opening and allow pancreas enzymes to flow normally. During surgery, a stent may be inserted into the duct to ensure that the duct will not close causing a blockage. As with any surgery, this operation is not risk-free. This surgery can cause pancreatitis in patients, or in rare cases, kidney failure and death.
References
- ↑ Jorge A. Soto, Brian C. Lucey, and Joshua W. Stuhlfaut. Pancreas Divisum: Depiction with Multi–Detector Row CT. Radiology 2005 235: 503-508.
- ↑ Yu, Jinxing, Turner, Mary Ann, Fulcher, Ann S., Halvorsen, Robert A. Congenital Anomalies and Normal Variants of the Pancreaticobiliary Tract and the Pancreas in Adults: Part 2, Pancreatic Duct and Pancreas. Am. J. Roentgenol. 2006 187: 1544-1553.