Pancreatic Divisum: An Unusual Cause of Chronic Pancreatitis in a Young Patient

Kuzel, Aaron R; Lodhi, Muhammad Uzair; Rahim, Mustafa

doi:10.7759/cureus.1856

Cited by 12 publications

(15 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 Its incidence has been reported to be of approximately 4-14% of the population. 20 In the present radiological study, it was of 7.76%. The three subtypes of pancreas divisum were identified in the present MRCP study, which is similar to the findings of Adibelli et al 7 and Kamisawa and Okamoto.…”

supporting

confidence: 39%

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

et al. 2019

View full text Add to dashboard Cite

Introduction Morphological variants of the pancreatobiliary system can predispose to chronic pancreatitis. The goal of the present study is to assess the prevalence of pancreatic duct patterns in the Indian population, both by cadaveric dissection and by magnetic resonance cholangiopancreatography (MRCP). Materials and Methods A total of 15 adult pancreas specimens of unknown age and gender, and 5 fetal pancreas specimens of different gestational ages with the intact second part of duodenum, were dissected by the piecemeal method. For clinical relevance, MRCP images of 103 clinically-diagnosed chronic pancreatitis patients irrespective of their etiology were obtained retrospectively from the existing database and studied. The anatomical patterns were classified as five different types based on the course of the main pancreatic duct and the accessory pancreatic duct and their openings into the duodenal wall, including variants like pancreas divisum and ansa pancreatica. Results In the cadaveric study, the main pancreatic duct was single with a straight course in 46.67% of the adult specimens, and in the MRCP study, the main pancreatic duct showed a descending course in 77.66% of the cases. The most common pattern was type III in both the cadaveric (80%) and radiological (55.33%) studies, and the accessory duct was absent on the MRCP in all type-III cases, while it ended blindly in the cadaveric specimens. Ansa pancreatica (type V) was observed in 1 adult specimen (6.7%), but not in the radiological study. Pancreas divisum (type IV) was observed in the 8 cases (7.76%) cases in the radiological study. Conclusion Knowledge of the anatomical variants of the pancreatic ductal system may be helpful for the radiologists during diagnostic and therapeutic interventional procedures.

show abstract

supporting

confidence: 39%

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…MRCP is considered a non-invasive approach that can visualize the pancreatic ducts without the using of contrast-enhanced material. 12 MRCP is also a sensitive method for diagnosing PD. 13 An evidence-based review 14 showed that the sensitivity and specificity of MRCP for PD was 52% and 97%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic pseudocyst, pancreatitis, and incomplete pancreas divisum in a child treated with endotherapy: a case report

et al. 2021

View full text Add to dashboard Cite

Pancreatic divisum (PD) is caused by the lack of fusion of the pancreatic duct during the embryonic period. Considering the incidence rate of PD, clinicians lack an understanding of the disease, which is usually asymptomatic. Some patients with PD may experience recurrent pancreatitis and progress to chronic pancreatitis. Recently, a 13-year-old boy presented with pancreatic pseudocyst, recurrent pancreatitis, and incomplete PD, and we report this patient’s clinical data regarding the diagnosis, medical imagining, and treatment. The patient had a history of recurrent pancreatitis and abdominal pain. Magnetic resonance cholangiopancreatography was chosen for diagnosis of PD, pancreatitis, and pancreatic pseudocyst, followed by endoscopic retrograde cholangiopancreatography, minor papillotomy, pancreatic pseudocyst drainage, and stent implantation. In the follow-up, the pseudocyst lesions were completely resolved, and no recurrent pancreatitis has been observed.

show abstract

“…Pancreatic Divisum (PD) occurs in approximately 4-14% of the population [7]. PD has geographic variations, where it is found in approximately 4-10% of the Caucasian population and 1-2% of the Asian population.…”

Section: Discussionmentioning

confidence: 99%

“…Type II pancreatic divisum is characterized by the absence of the ventral duct, so the minor papilla drains the entire pancreas and the major papilla drains some of the common bile duct. Finally, type III presents with a small remnant communication between the dorsal duct and ventral duct [7,8].…”

Section: Discussionmentioning

confidence: 99%

A Case of Late Presentation of Pancreatic Divisum in a Patient with Recurrent Pancreatitis

Sarkar

Jagroop

2020

Case Reports in Medicine

View full text Add to dashboard Cite

Pancreatic Divisum (PD) is the most common congenital variation of pancreatic duct anatomy, arising when embryological ventral and dorsal endodermal buds fail to fuse (“classic” PD) or only fuse partially (“incomplete” PD). Most patients with PD are asymptomatic, but a subgroup of patients can present with recurrent bouts of pancreatitis. While alcohol and gallstones are the common causes of acquired pancreatitis, PD is a congenital cause of pancreatitis. It is usually suspected in younger individuals with recurrent pancreatitis who also have a family history. Here, we present a rare case of PD in an older individual who presented with recurrent pancreatitis. He underwent cholecystectomy for suspected gallstone pancreatitis but continued to have episodes of pancreatitis. He had a history of alcohol abuse but denied use in the last one year. PD was detected later as the cause. Recurrent pancreatitis led to the development of a pseudocyst and pancreaticopleural fistula (PPF). Medical management improved the pseudocyst and PPF.

show abstract

Pancreatic Divisum: An Unusual Cause of Chronic Pancreatitis in a Young Patient

Cited by 12 publications

References 5 publications

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

Pancreatic pseudocyst, pancreatitis, and incomplete pancreas divisum in a child treated with endotherapy: a case report

A Case of Late Presentation of Pancreatic Divisum in a Patient with Recurrent Pancreatitis

Contact Info

Product

Resources

About