Disconnected pancreatic duct syndrome

Last revised by Matt A. Morgan on 13 Mar 2021

Disconnected pancreatic duct syndrome, also referred only as disconnected pancreatic duct, refers to the symptoms and complications due to the complete discontinuity of the main pancreatic duct between segments of viable secreting pancreatic tissue and the duodenum, usually seen as a sequela of necrotizing pancreatitis

For traumatic related pancreatic duct transection, please refer to the article on pancreatic trauma

Although mostly reported as a complication of acute necrotizing pancreatitis, it can be also seen after pancreatic traumatic injury with segmental necrosis 1,2

Endoscopic pancreatography shows active extravasation of contrast injected into the main pancreatic duct 1.

  • area of pancreatic necrosis/absence of normal parenchyma of at least 2 cm 1,3
  • normally enhancing pancreatic tissue upstream to this point 1,3
  • the angle between the walled-off necrosis and the pancreatic duct is nearly 90° 1,3

MR cholangiopancreatography (MRCP) enhanced with secretin is recommended as it can potentially enhance leakage 1.

Most cases will require surgery or endoscopic management 1-3

Pancreatic duct discontinuity is associated with leakage of the pancreatic enzymes and, therefore, has potential complications similar to pancreatitis.

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