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Pancreas divisum with Santorinicele

Case contributed by Dr Mohamed Saber


Severe upper abdominal pain with tenderness, nausea, and vomiting

Patient Data

Age: 15 years
Gender: Female

Marked fat blurring and free fluid surrounding the pancreatic head consistent with acute pancreatitis. Pancreatic ductal anatomical variation with dorsal main pancreatic duct drains dorsally into the minor ampulla and ventral duct does not communicate with the dorsal duct but joins with the distal CBD to enter the major ampulla. Moderate cystic dilatation of the main dorsal pancreatic duct along its course " Santorinicele".

Case Discussion

Pancreas divisum is a variation of pancreatic ductal anatomy. The main dorsal pancreatic duct of Santorini directly drains into the minor papilla with no communication with the ventral duct of Wirsung draining with the common bile duct into the major papilla. Usually associated with idiopathic pancreatitis and dilatation of main pancreatic duct "Santorinicele". In this case, the patient gave a history of recurrent attacks of acute pancreatitis. Her serum amylase was 1200 U/L at the time of the study. 

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