Pancreas divisum

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Right lower quadrant pain. Previous appendectomy.

Patient Data

Age: 35 years
Gender: Female
ct

CT abdomen normal, except for very mild periportal tracking and an undulating, mildly dilated, beaded main pancreatic duct (MPD). The appearance of the MPD is suggestive of early chronic pancreatitis (although no mention of pancreatitis in the patient's medical file).
The MPD drains into the minor duodenal papilla, while the common bile duct and the ventral pancreatic duct both drain into the major papilla.

Annotated image

Coronal minimum intensity projection (MinIP) showing the undulating main pancreatic duct (MPD)(orange arrowheads) and several of its tributaries. The leftmost (radiological rightmost) orange arrowhead points to the minor duodenal papilla, where the MPD drains. The common bile duct (CBD)(green arrowheads) and the duct of Wirsung (blue arrowhead) drain together into the major papilla.

Case Discussion

A case of classical pancreas divisum.

The main pancreatic duct is undulating, mildly dilated, and beaded, suggestive of chronic pancreatitis

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