Pancreas divisum

Answer 1

Definition

Pancreas divisum is a birth defect in which parts of the pancreas fail to join together. The pancreas is a long flat organ located between the stomach and spine that is involved in food digestion.

Causes, incidence, and risk factors

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 chemicals (enzymes) produced by the pancreas normally flow through this duct.

If the ducts fail to join together while the baby is developing in the womb, pancreas divisum results. Fluid from the two parts of the pancreas drains into separate areas of the upper portion of the small intestine (duodenum).

If the pancreatic ducts become blocked, swelling and tissue damage (pancreatitis) may develop.

Symptoms

• Abdominal pain, usually in the mid-abdomen, that may be felt in the back
• Abdominal swelling (distention)
• Nausea or vomiting

Note: There will not be symptoms if you do not have pancreatitis.

Signs and tests

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

Treatment

If you have this condition and have symptoms or pancreatitis that keeps returning, your doctor may recommend surgery.

Expectations (prognosis)

The outcome is usually good.

Complications

The main complication of pancreas divisum is pancreatitis.

Calling your health care provider

Call for an appointment with 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

Owyang C. Pancreatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 147.