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Journal of Radiological Review 2021 December;8(4):316-20

DOI: 10.23736/S2723-9284.21.00131-0


language: English

Acute pancreatitis in pancreas divisum secondary to a stone in the papilla minor

Gennaro CASABURO , Marcella CERRATO, Giovanna B. FIERRO, Gaetano CIMMINO, Giuseppe PANASCÌ

Unit of Radiology, San Paolo Hospital, ASL Napoli 1 Centro, Naples, Italy

The pancreas divisum is the most frequent congenital anomaly of those described in the pancreas with a prevalence of around 6-10%. Sometimes it can be associated with other pancreatic or even biliary abnormalities. It occurs in the seventh week of intrauterine life and is due to a lack of fusion of the ductal systems of the dorsal and ventral pancreatic buds, an event that leads to the formation of a dominant dorsal pancreatic duct which drains through the minor papilla and a small ventral pancreatic duct which drains through the major papilla. Over 95% of these patients do not have specific pancreatic symptoms and for this reason this anomaly is found incidentally on abdomen examinations often performed for other causes. We describe the case of a 62-year-old patient who came to our Emergency Room with abdominal pain. An initial urgent CT scan without contrast media show dilatation of a pancreatic duct in which a small lithiasic component was present at the junction with the duodenum. A subsequent CT scan and MRI reveals the presence of pancreas divisum. The etiological role and clinical significance of pancreas divisum in relation to pancreatic disease have not yet been clearly defined, but it is likely to predispose to pancreatic disease in coexistence with other factors. The formation of pancreatic stones is a rare event although its incidence is also increasing due to the improvement of diagnostic methods. The association of pancreatic stones is often associated with chronic pancreatitis but any condition that causes an increase in pressure and stasis of the secretion in the pancreatic ducts can lead to its production.

KEY WORDS: Pancreatitis; Pancreatitis, acute necrotizing; Case reports

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