Computed Tomography Findings in Pancreas Divisum

Abstract

In 29 patients with abdominal pain the diagnosis of pancreas divisum (PD) was verified by endoscopic retrograde pancreatography (ERP) via both the major and the minor papilla. Computed tomography (CT) was done in all patients to evaluate contour, volume, antero-posterior diameters and attenuation values of the gland in comparison with a normal reference series. Also, the validity of the CT grading of pancreatitis was assessed in comparison with ERP grading. Patients with PD had an increased cranio-caudal diameter of the pancreatic head (p<O.OOI). Further, the main pancreatic duct was visualized more often in patients with PD (p<O.OI), who also had an increasing frequency of pancreatic calcifications (p<O.05). Otherwise there were no differences compared with the normal series. The observed reduction in the volume of the gland in patients with marked pancreatitis at ERP seemingly reflected the severity of inflammation. No cleavage between the dorsal and ventral anlage was identified. CT was found to be too unspecific to be of any use in grading of pancreatitis. In conclusion, CT findings in patients with PD are sparse, unspecific and preferably a reflection of pancreatitis, if present. ERP remains the 'gold standard' for the diagnosis.

Imaging and Treatment Features of Idiopathic Pancreatitis and Pancreas Divisum in a Young Man: A Case Report

“…A standard CT of the pancreas may identify dilation of the dorsal duct and/or changes associated with chronic pancreatitis that are confined to the dorsal area of the pancreas. More commonly, the CT scan just shows nonspecific prominence of the pancreatic head and is no of diagnostic value [ 9 ]. Visualization of a fat plane between the dorsal and ventral portions can suggest pancreas divisum but does not generally separate symptomatic from coincidental states [ 10 ].…”