Pancreas divisum - recurrent acute pancreatitis

Case contributed by Dr Chris O'Donnell

Presentation

Recurrent acute pancreatitis. No cause evident, previous cholecystectomy.

Patient Data

Age: 75
Gender: Female

Swelling of the pancreatic head with inflammation in the adjacent fat.  CT cholangiogram post cholecystectomy shows no choledocholithiasis although there is an anatomical variant whereby the right posterior segmental duct enters the cystic duct stump.  This variant leads to substantial post-operative compilcations if the cystic duct is divided flush with the CBD.

Annotated image

Typical pancreas divisum whereby the main pancreatic duct enters the duodenum via the acessory duct (Santorini) more proximal to the ampulla of Vater.  CBD enters duodenum with the duct for the uncinate process.

Case Discussion

Pancreas divisum is relatively common and said to have an increased association with recurrent acute pancreatitis.

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Case information

rID: 26905
Case created: 13th Jan 2014
Last edited: 7th Oct 2015
Inclusion in quiz mode: Included

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