Pancreas divisum pathophysiology

• Variant of the pancreatic ductal system and occurs in 4%–10% of the population.
• Dorsal and ventral anlagen of the pancreas fail to fuse.
  • The dorsal duct drains most of the glandular parenchyma through the minor papilla.
  • The smaller ventral duct drains a portion of the pancreatic head, including the uncinate process, through the major papilla.
• Clinical relevance of pancreas divisum remains controversial.
  • Most patients with pancreas divisum are asymptomatic.
  • In some patients, this anomaly is associated with recurrent episodes of pancreatitis.
  • Postulated that in pancreas divisum, the duct of Santorini and the minor ampulla are too small to adequately drain the secretions produced by the pancreatic body and tail.

An association with adenoma of the minor papilla has been reported.^[1]

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