Pancreas Divisum is the most common congenital anomaly of the pancreas, affecting approximately 5–10% of the population . It occurs when the two ducts of the pancreas—the dorsal and ventral ducts—fail to fuse properly during fetal development. This results in two separate drainage pathways for pancreatic enzymes: the dorsal duct drains through the minor papilla, while the ventral duct drains through the major papilla.
🩺 Symptoms
Most individuals with pancreas divisum remain asymptomatic throughout their lives. However, in a minority of cases, particularly when the minor papilla becomes obstructed, symptoms may include:(en.wikipedia.org, nationalpancreasfoundations.org)
- Recurrent abdominal pain
- Nausea and vomiting
- Episodes of acute pancreatitis
- Chronic pancreatitis in some cases(en.wikipedia.org, nationalpancreasfoundations.org)
These symptoms are often similar to those of other pancreatic disorders, making diagnosis challenging .
🧪 Diagnosis
Pancreas divisum is typically diagnosed through imaging studies, including:
- Magnetic Resonance Cholangiopancreatography (MRCP): A non-invasive imaging technique that provides detailed images of the pancreatic ducts.
- Endoscopic Retrograde Cholangiopancreatography (ERCP): An invasive procedure that allows visualization and potential intervention within the pancreatic ducts.
- Endoscopic Ultrasound (EUS): Combines endoscopy and ultrasound to obtain detailed images of the pancreas.
- Secretin-Stimulated MRCP: Enhances the visibility of the pancreatic ducts by administering the hormone secretin during the MRCP .(medicoverhospitals.in)
💊 Treatment
For most individuals with pancreas divisum, no treatment is necessary. However, for those experiencing symptoms, treatment options may include:(my.clevelandclinic.org)
- Endoscopic Sphincterotomy: A procedure performed during ERCP to enlarge the minor papilla, facilitating better drainage of pancreatic enzymes.
- Stent Placement: Insertion of a stent to keep the duct open and prevent blockage.
- Surgical Intervention: In cases where endoscopic procedures are ineffective, surgery may be considered to create a more direct drainage pathway .(my.clevelandclinic.org, mountsinai.org)
Additionally, lifestyle modifications such as adhering to a low-fat diet and avoiding alcohol can help manage symptoms and reduce the risk of pancreatitis .(medicalnewstoday.com)