Pancreatic Divisum Clinical Presentation

Updated: Apr 23, 2018
  • Author: Rajan Kanth, MD; Chief Editor: BS Anand, MD  more...
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Presentation

History and Physical Examination

History

Pancreas divisum usually is a coincidental finding, and most individuals with this anomaly are asymptomatic.

It can be of clinical relevance in the following situations:

  • At endoscopic retrograde cholangiopancreatography (ERCP), the small ventral duct must be differentiated from various forms of main pancreatic duct cutoff, such as pancreatic cancer and pancreatic pseudocysts.

  • Dorsal pancreatic duct diseases can be missed because only the ventral portion of the pancreas can be viewed via standard major papilla cannulation.

  • Patients with symptomatic pancreas divisum present with pancreatitis or chronic abdominal pain. Pancreatitis can be acute recurrent pancreatitis or chronic pancreatitis. Patients with chronic abdominal pain can have a pain syndrome consistent with pancreatitis without an identifiable etiologic cause for pain (serum amylase, lipase, and imaging findings are normal).

Physical examination

The findings from an abdominal examination usually are normal. Epigastric tenderness and a palpable pseudocyst might be present during episodes of pancreatitis.