Pancreas divisum: magnetic resonance cholangiopancreatography findings

Pancreas divisum is a common congenital abnormality of the pancreas that results from the lack of fusion between the dorsal and ventral pancreatic ducts during foetal development. In these cases, the dorsal duct becomes the main pancreatic duct and drains most of the pancreas. Pancreas divisum is mainly asymptomatic, but the prevalence of pancreas divisum is higher in patients with chronic abdominal pain and idiopathic pancreatitis. A study of 20 patients with pancreas divisum (12 men and eight women; aged 19-77 years; mean age 39 years) and who underwent magnetic resonance cholangiopancreatography (MRCP), was performed. In our series, pancreas divisum was clinically manifested as unexplained episodes of abdominal pain (mean duration 3.2 years) (60 percent), mild pancreatitis (30 percent) or incidentally (ten percent). MRCP demonstrated non-communicating dorsal and ventral ducts, independent drainage sites, a dominant dorsal pancreatic duct, and a small cystic dilatation of the dorsal duct at minor papilla (santorinocoele). In this pictorial essay, we review the most common MRCP features of pancreas divisum.