Pancreas divisum

Infobox_Disease
Name = Pancreas divisum


Caption =
DiseasesDB = 31894
ICD10 = ICD10|Q|45|3|q|38
ICD9 = ICD9|751.7
ICDO =
OMIM =
MedlinePlus = 000247
eMedicineSubj = radio
eMedicineTopic = 520
MeshID =
Pancreas or 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.

Causes

The human embryo begins life with two ducts in the pancreas, these are the ventral duct and the dorsal duct. Normally, the two ducts will fuse together to form one main pancreatic duct; this occurs in more than 90% of embryos. In approximately 10% of embryos the ventral and dorsal ducts fail to fuse together, resulting in pancreas divisum. In utero, the majority of the pancreas is drained by the dorsal duct which opens up into the major papilla. The ventral duct drains the minority of the pancreas and opens into the minor papilla. In adults however, this situation is reversed whereby 70% of the pancreas is drained by the ventral duct. Therefore in pancreas divisum, where fusion of the ducts does not occur, the major drainage of the pancreas is done by the ventral duct which opens up into the minor papilla.

ymptoms

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.

Diagnosis

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. Other tests can assist doctor's with diagnosis, such as a CT scan and an MRI.

Treatment

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.

An association with adenoma of the minor papilla has been reported.cite journal |author=Nakamura Y, Tajiri T, Uchida E, "et al" |title=Adenoma of the minor papilla associated with pancreas divisum |journal=Hepatogastroenterology |volume=54 |issue=78 |pages=1841–3 |year=2007 |pmid=18019730 |doi=]

References

External links

* [http://www.medicinenet.com/pancreas_divisum/article.htm MedicineNet]
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