Pancreatic Pathology Online

Pathology of Pancreas Divisum  

Dr Sampurna Roy MD        

 

Pancreas divisum (PD), the most common congenital variant of pancreatic duct anatomy.

Developmental Defects of Pancreas.

The pancreas develops from ventral and the dorsal buds, which undergo fusion.

The major pancreatic duct (Wirsung's duct), drains the secretions from the head, body and tail of the exocrine pancreas, and ends at the major duodenal papilla (Papilla of vater).

The accessory pancreatic duct (Santorini's duct) extends through the head of the pancreas, crosses Wirsung's duct and ends at the minor duodenal papilla.

Both pancreatic outlets are located on the medial wall of the second part of the duodenum.

The minor papilla are above, the major duodenal papilla below.

Pancreas divisum occurs when the ductal systems of the ventral and dorsal pancreatic ducts fail to fuse during the second month of gestation. 

With non-union of the ducts, the major portion of the pancreatic exocrine secretion enters the duodenum by way of the dorsal duct and minor papilla.

A relative obstruction to pancreatic exocrine secretory flow through the minor duct and minor papilla could result in pancreatitis in small numbers of patients with pancreas divisum.

Endoscopic retrograde cholangiopancreatography (ERCP) is the most common procedure for diagnosis pancreas divisum in patients who have pancreatobiliary symptoms

 

Further reading:

Pancreas divisum--a rare cause of chronic pancreatitis.

Pancreas divisum does not modify the natural course of chronic pancreatitis.

Pancreas divisum: A common developmental variant that deserves attention in preclinical medical education.

Acute non-traumatic pancreatitis in a patient with pancreas divisum: a case report.

The Frey procedure for chronic pancreatitis secondary to pancreas divisum

Pancreatitis in patients with pancreas divisum: imaging features at MRI and MRCP

Complete pancreas divisum with patulous minor papilla complicated by multifocal branch-duct intraductal papillary mucinous neoplasms.

A patient with pancreas divisum, recurrent acute pancreatitis, and homozygosity for the cystic fibrosis transmembrane regulator-associated protein 5T allele.

Clinical importance of pancreas divisum.

Carcinoid tumor of the minor papilla in complete pancreas divisum presenting as recurrent abdominal pain

First case of 2 intraductal papillary mucinous tumors of both ventral and dorsal ducts in pancreas divisum.

Small pancreatic cancer with pancreas divisum preoperatively diagnosed by pancreatic juice cytology.

Pancreas divisum in pancreaticobiliary maljunction.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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