Ventral duct pancreaticolithiasis in pancreas divisum

Pancreas divisum, partial or nonfusion of the dorsal and ventral pancreatic ductal systems, affects up to 10 per cent of the population. Approximately 25 per cent of patients with pancreas divisum will develop complications such as recurrent pancreatitis as a consequence of stenosis of the minor papilla with altered dorsal duct drainage. Surgical and endoscopic therapy usually include minor papilla sphincterotomy or sphincteroplasty to facilitate drainage of the dorsal ductal system. The following case represents an unusual complication of pancreas divisum with primarily ventral duct disease and pancreaticolithiasis.