Pancreas divisum: a reemerging risk factor for pancreatic diseases

Area of Science:

• Gastroenterology and Hepatology
• Anatomical Pathology
• Surgical Gastroenterology

Background:

• Pancreas divisum (PD) is the most prevalent congenital anomaly of the pancreatic duct system.
• Growing evidence links PD to recurrent acute pancreatitis, chronic pancreatitis, and chronic abdominal pain.
• PD is also associated with an increased risk of developing pancreatic tumors.

Purpose of the Study:

• To review the pathophysiology of pancreas divisum.
• To discuss diagnostic methods for PD.
• To outline the risks, including pancreatitis and tumors, and treatment options for PD.

Main Methods:

• Literature review of studies on pancreas divisum.
• Analysis of diagnostic modalities including ERCP and MRCP with secretin.
• Evaluation of treatment strategies for symptomatic PD.

Main Results:

• PD is associated with pancreatic pathologies such as pancreatitis and tumors (up to 12.5% of cases).
• Magnetic resonance cholangiopancreatography with secretin is a viable alternative to invasive ERCP for diagnosis.
• Symptomatic patients may benefit from endoscopic or surgical interventions.

Conclusions:

• Pancreas divisum is a significant anatomical variant with clinical implications for pancreatic health.
• Accurate diagnosis and timely management are crucial for patients with symptomatic PD.
• Further research into PD's role in pancreatic carcinogenesis is warranted.