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Pancreas divisum

Pancreatic divisum

 

Pancreas divisum is a birth defect in which parts of the pancreas do not join together. The pancreas is a long, flat organ located between the stomach and spine. It helps in food digestion.

Causes

 

Pancreas divisum is the most common birth defect of the pancreas. In many cases, this defect goes undetected and causes no problems. The cause of the defect is unknown.

As a baby develops in the womb, 2 separate pieces of tissue join together to form the pancreas. Each part has a tube, called a duct. When the parts join together, a final duct, called the pancreatic duct, is formed. Fluid and digestive juices (enzymes) produced by the pancreas normally flow through this duct.

If the ducts do not join while the baby is developing in the womb, pancreas divisum results. Fluid from the 2 parts of the pancreas drains into separate areas of the upper portion of the small intestine (duodenum). This occurs in 5% to 15% of people.

If a pancreatic duct becomes blocked, swelling and tissue damage (pancreatitis) may develop.

 

Symptoms

 

Symptoms include:

  • Abdominal pain, most often in the mid-abdomen, that may be felt in the back
  • Abdominal swelling (distention)
  • Nausea or vomiting

Note: Unless you have pancreatitis, you will not have symptoms.

 

Exams and Tests

 

You may have the following tests:

  • Abdominal ultrasound
  • Abdominal CT scan
  • Amylase and lipase blood test
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Endoscopic ultrasound (EUS)

 

Treatment

 

The following treatments may be needed if you have symptoms of the condition, or if pancreatitis keeps returning:

  • ERCP with a cut to enlarge the opening where the pancreatic duct drains
  • Placement of a stent to prevent the duct from getting blocked

You may need surgery if these treatments do not work.

 

Outlook (Prognosis)

 

Most of the time, the outcome is good.

 

Possible Complications

 

The main complication of pancreas divisum is pancreatitis.

 

When to Contact a Medical Professional

 

Call your health care provider if you develop symptoms of this disorder.

 

Prevention

 

Because this condition is present at birth, there is no known way to prevent it.

 

 

References

Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 144.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Endocrine glands

    Endocrine glands - illustration

    Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

    Endocrine glands

    illustration

  • Pancreas

    Pancreas - illustration

    The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.

    Pancreas

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Endocrine glands

      Endocrine glands - illustration

      Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

      Endocrine glands

      illustration

    • Pancreas

      Pancreas - illustration

      The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.

      Pancreas

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Pancreas divisum

         

           

          Review Date: 10/27/2015

          Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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