Fact-sheet: Pancreas divisum


Updated on 09/10/2024 at 1:22 PM

Note : 9.6666666666667/10 ( 3 notes )
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Definition

Congenital anomaly of the pancreas resulting from a fusion defect between the dorsal and ventral pancreatic ducts.

In pancreas divisum, the main pancreatic drainage occurs through the minor papilla.

Clinical features

Incidence:

  • 5 to 10% of the general population
  • Increased in patients with CFTR mutations

Asymptomatic or presenting as acute pancreatitis.

Pancreas divisum is not a cause of chronic pancreatitis

MRI

  • The main pancreatic duct (dorsal pancreatic duct) drains into the minor papilla = dominant dorsal duct.
  • Crossing sign on MR cholangiography sequences (main pancreatic duct crosses the common bile duct)
  • The common bile duct and the ventral duct (= duct of Santorini) drain into the major papilla - except in cases of isolated dorsal duct

Classification

  • Modal anatomy = drainage of the common bile duct and main pancreatic duct into the major papilla. The duct of Santorini may communicate with the main pancreatic duct but must be smaller than the main pancreatic duct.

Pancreas Anatomie modale

  • Type I = complete pancreas divisum (70%)

Pancreas divisum complet

  • Type II = isolated dorsal duct (20-25%) --> the ventral duct drains into the main pancreatic duct

Pancreas Canal dorsal isolé

  • Type III = incomplete pancreas divisum (5%)

Pancreas divisum incomplet