What is pancreas divisum? Is it associated with an increased incidence of recurrent acute pancreatitis?
Pancreas divisum is the most common congenital variant of the pancreatic anatomy, occurring in approximately 5-10% of the population. It results when the embryologic dorsal and ventral pancreases fail to fuse, causing most of the pancreatic exocrine secretions to drain through the duct of Santorini (dorsal duct) and through the smaller minor papilla into the duodenum. Normally, pancreatic drainage flows through the duct of Wirsung (ventral duct) and through the larger major papilla into the duodenum. Pancreas divisum is usually diagnosed by endoscopic retrograde pancreatography (ERP) but may also be diagnosed by magnetic resonance cholangiopancreatography (MRCP), with or without secretin and endoscopic ultrasound (EUS). Whether pancreas divisum causes recurrent AP is controversial. Ninety-five percent of people with pancreas divisum are asymptomatic, and their anomaly is discovered incidentally. It is, however, generally accepted that the combination of pancreas divisum along with a st
