Pancreas Divisum

Before a baby is born, around the eighth week of pregnancy, two important pieces of tissues typically join together within the fetus to form the pancreas, and the two tubes running through those tissues join together to create the main pancreatic duct.  About 5-10 percent of the time, the ducts do not connect and pancreas divisum results with digestive enzymes flowing out of the pancreas through two ducts on their way to the small intestine.

Most people with pancreas divisum will never know it. Others will have recurring episodes of pancreatitis that likely result from poor drainage of the smaller duct (duct of Santorini) and narrower exit (minor papilla) which unfortunately wind up doing most of the work in this arrangement. Pain may result from the building pressure of pancreatic juices as well as the inflammation and resulting damage of pancreatitis.

For many years, MUSC has established its expertise in using use endoscopic treatment to improve drainage of the smaller duct in pancreas divisum patients. However, if there is scarring around the duct, MUSC is equally prepared to use surgery to provide relief. Options include the Puestow procedure in which the pancreatic ductwork is opened up and connected directly to the small intestine, bypassing potential problems.  Removal of the head of the pancreas through the Whipple procedure might be considered as well.

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