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At the time the article was created Hamish Smith had no recorded disclosures.View Hamish Smith's current disclosures
At the time the article was last revised Frank Gaillard had the following disclosures:
- Biogen Australia Pty Ltd, Investigator-Initiated Research Grant for CAD software in multiple sclerosis: finished Oct 2021 (past)
These were assessed during peer review and were determined to not be relevant to the changes that were made.View Frank Gaillard's current disclosures
Fishtail pancreas (also known as pancreas bifidum or bifid tail of the pancreas) is a rare anatomical variant of the pancreas produced by a branching anomaly during its development. It is named as such due to the fishtail-like appearance of the pancreas.
It is a rare anatomical anomaly with only a small number of cases reported, its exact prevalence is unknown in the general population 1. In one study of patients with duplication variants of the pancreatic ductal system on ERCP, patients with fishtail pancreas represented less than 1% of these anomalies 2.
Fishtail pancreas is usually an asymptomatic anomaly detected incidentally on imaging performed for other indications 1.
Fishtail pancreas is thought to be caused by the failure of part of the ventral pancreatic anlage to regress. The ventral pancreatic anlage develops into the majority of the pancreatic gland 2. During pancreatic development, the ventral anlage initially has two lobes with two primitive ducts 3. One lobe tends to dominate and persists to become the head of the pancreas, while the other regresses and becomes the uncinate process of the pancreas. Fishtail pancreas is caused by failure of one of these lobes to regress producing duplication of the main pancreatic duct creating a dorsal and ventral tail 1.
Fishtail pancreas may be visible as a duplication of the major duct in the body of the pancreas and the presence of two pancreatic tails 4.
Like MRCP, on ERCP it also shows duplication of the major pancreatic duct 4.
Treatment and prognosis
No treatment is necessary for fishtail pancreas 5. In patients with fishtail pancreas pancreatitis has been reported to occur in a single tail as opposed to both 6. Due to the rarity of this variant it is unclear if patients with fishtail pancreas are at higher risk of acute pancreatitis or other pancreatic disease 1.
- 1. Atif Zaheer, Elliot K. Fishman, Meredith E. Pittman, Ralph H. Hruban. Pancreatic Imaging. (2017) ISBN: 9783319526805
- 2. Uomo G, Manes G, D'Anna L, Laccetti M, Di Gaeta S, Rabitti PG. Fusion and duplication variants of pancreatic duct system. Clinical and pancreatographic evaluation. (1995) International journal of pancreatology : official journal of the International Association of Pancreatology. 17 (1): 23-8. doi:10.1007/BF02788355 - Pubmed
- 3. Odgers PN. Some Observations on the Development of the Ventral Pancreas in Man. (1930) Journal of anatomy. 65 (Pt 1): 1-7. Pubmed
- 4. Shim JR, Park SJ, Park HM, Lee EC, Han SS. Are you prepared for pancreas bifidum? A case report. (2018) Annals of surgical treatment and research. 94 (1): 49-51. doi:10.4174/astr.2018.94.1.49 - Pubmed
- 5. Dinter D, Löhr JM, Neff KW. Bifid tail of the pancreas: benign bifurcation anomaly. (2007) AJR. American journal of roentgenology. 189 (5): W251-3. doi:10.2214/AJR.05.1453 - Pubmed
- 6. Kahramanoglu Aksoy E, Koklu S, Öztürk Ö, Karcaaltincaba M. An Unusual Cause of Recurrent Acute Pancreatitis. (2016) Pancreas. 45 (1): e11-2. doi:10.1097/MPA.0000000000000422 - Pubmed