Pancreas divisum: is it a normal anatomic variant?

Area of Science:

• Gastroenterology
• Anatomy
• Radiology

Background:

• Pancreas divisum is a congenital anomaly of the pancreatic duct system.
• Its clinical significance, particularly in relation to pancreatitis and abdominal pain, remains debated.

Purpose of the Study:

• To determine the incidence of pancreas divisum.
• To investigate the association between pancreas divisum and various pancreatic conditions, including alcoholic and idiopathic pancreatitis.
• To evaluate the efficacy of surgical intervention for pancreas divisum.

Main Methods:

• Retrospective analysis of 1,529 pancreatograms.
• Categorization of patients into groups: incidental findings, alcoholic pancreatitis, unexplained upper abdominal pain, and idiopathic pancreatitis.
• Review of outcomes for patients who underwent sphincteroplasty of the minor papilla.

Main Results:

• The incidence of complete pancreas divisum was 2.7% (41/1529), and incomplete pancreas divisum was 0.9% (14/1529).
• No increased incidence of pancreas divisum was observed in patients with alcoholic pancreatitis, unexplained upper abdominal pain, or idiopathic pancreatitis.
• Pancreas divisum was most frequently an incidental finding (80%) or associated with alcoholic pancreatitis.
• Only 2 out of 82 patients with idiopathic pancreatitis had pancreas divisum.
• Sphincteroplasty of the minor papilla provided no relief for the three treated patients.

Conclusions:

• Pancreas divisum is a common anatomical variant with a low incidence of 3.6%.
• It is rarely a cause of pancreatic pain and is not significantly associated with alcoholic or idiopathic pancreatitis.
• Surgical intervention, such as sphincteroplasty, is generally ineffective for pancreas divisum-related symptoms.