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Pancreas divisum

Pancreatic divisum

Pancreas divisum is a birth defect in which parts of the pancreas do not join together. The pancreas is a long, flat organ located between the stomach and spine. It helps in food digestion.

Causes

Pancreas divisum is the most common birth defect of the pancreas. In many cases, this defect goes undetected and causes no problems. The cause of the defect is unknown.

As a baby develops in the womb, two separate pieces of tissue join together to form the pancreas. Each part has a tube, called a duct. When the parts join together, a final duct, called the pancreatic duct, is formed. Fluid and digestive juices (enzymes) produced by the pancreas normally flow through this duct.

Pancreas divisum occurs if the ducts do not join while the baby develops. Fluid from the two parts of the pancreas drains into separate areas of the upper portion of the small intestine (duodenum). This occurs in 5% to 15% of people.

If a pancreatic duct becomes blocked, swelling and tissue damage (pancreatitis) may develop.

Symptoms

Many people do not have any symptoms. If you have pancreatitis, symptoms include:

Exams and Tests

You may have the following tests:

  • Abdominal ultrasound
  • Abdominal CT scan
  • Amylase and lipase blood test
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Endoscopic ultrasound (EUS)

Treatment

The following treatments may be needed if you have symptoms of the condition, or if pancreatitis keeps returning:

  • ERCP with a cut to enlarge the opening where the pancreatic duct drains
  • Placement of a stent to prevent the duct from getting blocked

You may need surgery if these treatments do not work.

Outlook (Prognosis)

Most of the time, the outcome is good.

Possible Complications

The main complication of pancreas divisum is pancreatitis.

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of this disorder.

Prevention

Because this condition is present at birth, there is no known way to prevent it.

References

Adams DB, Cote GA. Pancreas divisum and other variants of dominant dorsal duct anatomy. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017:502-509.

Barth BA, Husain SZ. Anatomy, histology, embryology and developmental anomalies of the pancreas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 55.

Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 144.

  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Endocrine glands

    Endocrine glands - illustration

    Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

    Endocrine glands

    illustration

  • Pancreas

    Pancreas - illustration

    The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.

    Pancreas

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Endocrine glands

      Endocrine glands - illustration

      Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

      Endocrine glands

      illustration

    • Pancreas

      Pancreas - illustration

      The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.

      Pancreas

      illustration

     

    Review Date: 9/29/2017

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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