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Acute Pancreatitis II: Clinical Manifestations and Management

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...

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Assessment:

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Related Experiment Video

Updated: Jun 13, 2026

Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy

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Pancreas divisum. Detection and management.

J A Madura, A C Fiore, K W O'Connor

The American Surgeon

|June 1, 1985

Summary

Pancreas divisum, a pancreatic duct variant, can cause severe pain. Dual sphincteroplasty offers relief for some patients, with 70% asymptomatic post-procedure, though complications occur.

Area of Science:

Gastroenterology
Surgical Innovation
Anatomical Variants

Background:

Pancreas divisum is an increasingly recognized variant of pancreatic ductal anatomy.
Relative stenosis of the accessory pancreatic sphincter can lead to symptoms like nausea, vomiting, abdominal pain, and pancreatitis.
Endoscopic retrograde cholangiopancreatography (ERCP) aids in identifying pancreas divisum.

Purpose of the Study:

To evaluate the efficacy and safety of transduodenal sphincteroplasty for symptomatic pancreas divisum.
To assess diagnostic tools for identifying patients who may benefit from surgical intervention.

Main Methods:

Studied 20 patients with symptomatic pancreas divisum over four years.
Utilized morphine-prostigmine stimulation and intravenous secretin for diagnosis and duct cannulation.

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Last Updated: Jun 13, 2026

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Performed operative common duct manometry and pathological examination of gallbladders.

Main Results:

Morphine-prostigmine stimulation was effective in 79% of patients.
40% of patients showed abnormal flow dynamics on manometry.
Dual sphincteroplasty had no mortalities but a 50% complication rate.
70% of patients were asymptomatic at follow-up; some experienced recurrent pancreatitis or other post-operative pain.

Conclusions:

Dual sphincteroplasty is an acceptable treatment for pancreas divisum when other pain sources are excluded.
Further long-term follow-up is required to confirm the curative potential of the procedure.