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Pancreas divisum: is it a normal anatomic variant?

C Sugawa, A J Walt, D C Nunez

    American Journal of Surgery
    |January 1, 1987
    PubMed
    Summary

    Pancreas divisum, an anatomical variant, occurs in 3.6% of patients. This study found it rarely causes pancreatic pain, even in cases of alcoholic or idiopathic pancreatitis.

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    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.

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