[Pancreas divisum as a possible cause of misinterpretation in ERCP, computed tomography, sonography and MDP]

In 488 patients endoscopic retrograde pancreatography (ERP) revealed a pancreas divisum in 21 (4.3%): in 17/21 patients we found a complete, in 4/21 an incomplete separation of the pancreatic ducts. The pancreas divisum is caused by a malfusion of the ductal system. On examination by ultrasound, computed tomography or hypotonic duodenography this variant can suggest an inflammation or tumour of the head of the pancreas. A definite diagnosis is possible by ERP only. Since the small ventral duct can be confused with an alteration caused by inflammation or by a tumour, to much of contrast medium can be injected. Pancreas divisum is often associated with a chronic pancreatitis which can be demonstrated via ERP of the dorsal duct through the accessory papilla.