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Pancreas divisum

Pancreatic divisum

Pancreas divisum is a birth defect in which parts of the pancreas do not join together. The pancreas is a long, flat organ located between the stomach and spine. It helps in food digestion.

Causes

Pancreas divisum is the most common birth defect of the pancreas. In many cases, this defect goes undetected and causes no problems. The cause of the defect is unknown.

As a baby develops in the womb, two separate pieces of tissue join together to form the pancreas. Each part has a tube, called a duct. When the parts join together, a final duct, called the pancreatic duct, is formed. Fluid and digestive juices (enzymes) produced by the pancreas normally flow through this duct.

Pancreas divisum occurs if the ducts do not join while the baby develops. Fluid from the two parts of the pancreas drains into separate areas of the upper portion of the small intestine (duodenum). This occurs in 5% to 15% of people.

If a pancreatic duct becomes blocked, swelling and tissue damage (pancreatitis) may develop.

Symptoms

Many people do not have any symptoms. If you have pancreatitis, symptoms include:

Exams and Tests

You may have the following tests:

  • Abdominal ultrasound
  • Abdominal CT scan
  • Amylase and lipase blood test
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Endoscopic ultrasound (EUS)

Treatment

The following treatments may be needed if you have symptoms of the condition, or if pancreatitis keeps returning:

  • ERCP with a cut to enlarge the opening where the pancreatic duct drains
  • Placement of a stent to prevent the duct from getting blocked

You may need surgery if these treatments do not work.

Outlook (Prognosis)

Most of the time, the outcome is good.

Possible Complications

The main complication of pancreas divisum is pancreatitis.

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of this disorder.

Prevention

Because this condition is present at birth, there is no known way to prevent it.

References

Adams DB, Cote GA. Pancreas divisum and other variants of dominant dorsal duct anatomy. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017:502-509.

Barth BA, Husain SZ. Anatomy, histology, embryology and developmental anomalies of the pancreas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 55.

Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 144.

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    • Digestive system

      Digestive system

      illustration

    • Endocrine glands

      Endocrine glands

      illustration

    • Pancreas

      Pancreas

      illustration

      • Digestive system

        Digestive system

        illustration

      • Endocrine glands

        Endocrine glands

        illustration

      • Pancreas

        Pancreas

        illustration

       

      Review Date: 9/29/2017

      Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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