Pancreatitis in Patients with Pancreas Divisum

Adike, Abimbola; Kurdi, Bara El; Gaddam, Sathvika; Kosiorek, Heidi E.; Pannala, Rahul; Harrison, M. Edwyn; Fukami, Norio; Faigel, Douglas O.; Collins, Joseph M.; Ramirez, Francisco C.

doi:10.14309/00000434-201610001-00068

Cited by 3 publications

(4 citation statements)

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“…In addition, the CT study performed in 2017 exhibited a 10-mm calcification in the head of the pancreas that is consistent with chronic pancreatitis. To rule out cystic fibrosis as the recurrent cause of pancreatitis, a sweat chloride test and CFTR genetic testing were administered but returned negative [ 5 ]. Given the patient’s family medical history is negative for cystic fibrosis as well as any medical issues involving the pancreas, the patient is unlikely to have cystic fibrosis or hereditary pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

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

Kuzel

Lodhi²,

Rahim³

2017

Cureus

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Pancreatic divisum is a condition that occurs in 4-14% of the population. Pancreatic divisum occurs in development when the ventral bud and dorsal bud of the pancreas fail to fuse. Patients with this condition are usually asymptomatic, however, 25-38% of these patients experience recurrent pancreatitis that may further progress to chronic pancreatitis. This case is of a 20-year-old female presenting with abdominal pain in the left and right upper quadrants of the abdomen with a significant history of recurrent pancreatitis since the age of seven. The patient was examined with computed tomography (CT), which identified pancreatitis. Further magnetic resonance cholangiopancreatography (MRCP) assisted in the diagnosis of a type III pancreatic divisum, given the remnant of short communication between the dorsal and ventral duct.

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Section: Discussionmentioning

confidence: 99%

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

Kuzel

Lodhi²,

Rahim³

2017

Cureus

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“…There is increasing evidence that PD does not cause pancreatitis but is associated with genetic mutation. 12,13 Therefore, it is important to perform genetic testing on pediatric cases of pancreatitis caused by PD. In contrast to the cystic fibrosis transmembrane conductance regulator (CFTR) gene and SPINK1…”

Section: Discussionmentioning

confidence: 99%

“…Gene mutations were detected in 51.6% of patients with PD and 50.0% of those with AnnP, respectively. There is increasing evidence that PD does not cause pancreatitis but is associated with genetic mutation 12,13 . Therefore, it is important to perform genetic testing on pediatric cases of pancreatitis caused by PD.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and endoscopic treatment of pancreatitis caused by pancreaticobiliary malformation in Chinese children

Zhang

Deng

Gong

2022

J of Digest Diseases

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Objectives We aimed to describe the clinical characteristics of pediatric patients with pancreatitis caused by pancreaticobiliary malformation and to evaluate the efficacy and safety of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of the disease. Methods Medical records of pediatric patients with pancreatitis related to pancreaticobiliary malformation diagnosed by ERCP and treated in our hospital between April 2008 and December 2020 were retrospectively reviewed. Clinical manifestations, laboratory indicators, genetic testing results and imaging findings including MRCP were collected. Results Of the 148 patients with pancreaticobiliary malformation‐related pancreatitis, 90 (60.8%) had pancreaticobiliary maljunction (PBM), 52 (35.1%) had pancreatic divisum (PD), and six (4.1%) had annular pancreas (AnnP). Compared with the PD group, patients with PBM were younger (P < 0.001), and were more likely to have jaundice (P < 0.001) and fever (P = 0.034). Genetic mutation was found in 51.6% of patients with PD, 50.0% with AnnP, and 15.0% with PBM. Diagnostic rate of PBM, PD, and AnnP using MRCP was 46.7%, 15.4%, and 100%, respectively. In total, 87.8% of patients had symptomatic improvement after endoscopic treatment. ERCP‐related complications were observed in 28 out of the 260 procedures, including post‐ERCP pancreatitis (7.7%), infection (2.3%), and gastrointestinal bleeding (0.8%). Conclusions PBM should be considered when jaundice and fever occur in pediatric patients. Genetic testing is recommended for those with PD and AnnP. The role of MRCP is limited in identifying pancreaticobiliary malformation in children. ERCP is effective and safe for the diagnosis and treatment for pediatric pancreatitis caused by pancreaticobiliary malformation.

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“…Only 5% of patients with divisum develop CP, RAP, or chronic abdominal pain [19]. A recent study demonstrated that younger age and alcohol use significantly increased the risk of developing pancreatitis in the setting of divisum [20].…”

Section: Why We Use Secretin Established Indications For Secretinmentioning

confidence: 99%

Secretin-Enhanced MRCP: How and Why—AJR Expert Panel Narrative Review

Swensson

Zaheer

Conwell

et al. 2021

American Journal of Roentgenology

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Secretin-enhanced MRCP (S-MRCP) provides multiple advantages compared with standard MRCP for imaging the pancreaticobiliary tree. By using secretin to induce fluid production from the pancreas, and leveraging fluid-sensitive MRCP sequences, S-MRCP increases visualization of ductal anatomy and provides insight into pancreatic function, allowing radiologists to offer additional insight for a range of pancreatic-related conditions. This narrative review provides detailed information on the practical implementation of S-MRCP, including patient preparation, logistics of secretin administration, and dynamic secretin-enhanced MRCP acquisition. Considerations are given for radiologists' interpretation and reporting of S-MRCP examinations, including assessment of dynamic compliance of the main pancreatic duct and of duodenal fluid volume. Established indications for S-MRCP are reviewed, including pancreas divisum, anomalous pancreaticobiliary junction, Santorinicele, Wirsungocele, chronic pancreatitis, main pancreatic duct stenosis, and assessment of complex postoperative anatomy. Equivocal or controversial indications are also presented, along with the authors' approach to such indications; these include acute or recurrent acute pancreatitis, pancreatic exocrine function, sphincter of Oddi dysfunction, and pancreatic neoplasms.

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Pancreatitis in Patients with Pancreas Divisum

Cited by 3 publications

References 0 publications

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

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

Clinical characteristics and endoscopic treatment of pancreatitis caused by pancreaticobiliary malformation in Chinese children

Secretin-Enhanced MRCP: How and Why—AJR Expert Panel Narrative Review

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