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Pancreas Divisum
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Anatomic variant of pancreatic ductal anatomy resulting from failure of ventral and dorsal pancreatic buds to fuse

        IMAGING

        • General Features

          • MR Findings

            • CT Findings

              • Radiographic Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Tirkes T et al: Secretin-enhanced MR cholangiopancreatography: spectrum of findings. Radiographics. 33(7):1889-906, 2013
                                          2. T├╝rkvatan A et al: Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol. 14(6):905-13, 2013
                                          3. Asayama Y et al: Detectability of pancreas divisum in patients with acute pancreatitis on multi-detector row computed tomography. Emerg Radiol. 19(2):121-5, 2012
                                          4. Bertin C et al: Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol. 107(2):311-7, 2012
                                          5. Mosler P et al: Accuracy of magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum. Dig Dis Sci. 57(1):170-4, 2012
                                          6. Pezzilli R: Pancreas divisum and acute or chronic pancreatitis. JOP. 13(1):118-9, 2012
                                          7. Anderson SW et al: Pancreatic duct evaluation: accuracy of portal venous phase 64 MDCT. Abdom Imaging. 34(1):55-63, 2009
                                          8. Soto JA et al: Pancreas divisum: depiction with multi-detector row CT. Radiology. 235(2):503-8, 2005
                                          9. Khalid A et al: Secretin-stimulated magnetic resonance pancreaticogram to assess pancreatic duct outflow obstruction in evaluation of idiopathic acute recurrent pancreatitis: a pilot study. Dig Dis Sci. 48(8):1475-81, 2003
                                          10. Mishra D et al: Pancreas divisum: an uncommon cause of acute pancreatitis. Indian J Pediatr. 70(7):593-5, 2003
                                          11. Benya EC: Pancreas and biliary system: imaging of developmental anomalies and diseases unique to children. Radiol Clin North Am. 40(6):1355-62, 2002
                                          12. Manfredi R et al: Idiopathic chronic pancreatitis in children: MR cholangiopancreatography after secretin administration. Radiology. 224(3):675-82, 2002
                                          13. Masatsugu T et al: Serous cystadenoma of the pancreas associated with pancreas divisum. J Gastroenterol. 37(8):669-73, 2002
                                          14. Vitellas KM et al: MR cholangiopancreatography of bile and pancreatic duct abnormalities with emphasis on the single-shot fast spin-echo technique. Radiographics. 20(4):939-57; quiz 1107-8, 1112, 2000
                                          15. Fulcher AS et al: MR cholangiography: technical advances and clinical applications. Radiographics. 19(1):25-41; discussion 41-4, 1999
                                          16. Morgan DE et al: Pancreas divisum: implications for diagnostic and therapeutic pancreatography. AJR Am J Roentgenol. 173(1):193-8, 1999
                                          17. Bret PM et al: Pancreas divisum: evaluation with MR cholangiopancreatography. Radiology. 199(1):99-103, 1996
                                          18. Rizzo RJ et al: Congenital abnormalities of the pancreas and biliary tree in adults. Radiographics. 15(1):49-68; quiz 147-8, 1995
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Definitions

                                                  • Anatomic variant of pancreatic ductal anatomy resulting from failure of ventral and dorsal pancreatic buds to fuse

                                                IMAGING

                                                • General Features

                                                  • MR Findings

                                                    • CT Findings

                                                      • Radiographic Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Tirkes T et al: Secretin-enhanced MR cholangiopancreatography: spectrum of findings. Radiographics. 33(7):1889-906, 2013
                                                                                  2. T├╝rkvatan A et al: Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol. 14(6):905-13, 2013
                                                                                  3. Asayama Y et al: Detectability of pancreas divisum in patients with acute pancreatitis on multi-detector row computed tomography. Emerg Radiol. 19(2):121-5, 2012
                                                                                  4. Bertin C et al: Pancreas divisum is not a cause of pancreatitis by itself but acts as a partner of genetic mutations. Am J Gastroenterol. 107(2):311-7, 2012
                                                                                  5. Mosler P et al: Accuracy of magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum. Dig Dis Sci. 57(1):170-4, 2012
                                                                                  6. Pezzilli R: Pancreas divisum and acute or chronic pancreatitis. JOP. 13(1):118-9, 2012
                                                                                  7. Anderson SW et al: Pancreatic duct evaluation: accuracy of portal venous phase 64 MDCT. Abdom Imaging. 34(1):55-63, 2009
                                                                                  8. Soto JA et al: Pancreas divisum: depiction with multi-detector row CT. Radiology. 235(2):503-8, 2005
                                                                                  9. Khalid A et al: Secretin-stimulated magnetic resonance pancreaticogram to assess pancreatic duct outflow obstruction in evaluation of idiopathic acute recurrent pancreatitis: a pilot study. Dig Dis Sci. 48(8):1475-81, 2003
                                                                                  10. Mishra D et al: Pancreas divisum: an uncommon cause of acute pancreatitis. Indian J Pediatr. 70(7):593-5, 2003
                                                                                  11. Benya EC: Pancreas and biliary system: imaging of developmental anomalies and diseases unique to children. Radiol Clin North Am. 40(6):1355-62, 2002
                                                                                  12. Manfredi R et al: Idiopathic chronic pancreatitis in children: MR cholangiopancreatography after secretin administration. Radiology. 224(3):675-82, 2002
                                                                                  13. Masatsugu T et al: Serous cystadenoma of the pancreas associated with pancreas divisum. J Gastroenterol. 37(8):669-73, 2002
                                                                                  14. Vitellas KM et al: MR cholangiopancreatography of bile and pancreatic duct abnormalities with emphasis on the single-shot fast spin-echo technique. Radiographics. 20(4):939-57; quiz 1107-8, 1112, 2000
                                                                                  15. Fulcher AS et al: MR cholangiography: technical advances and clinical applications. Radiographics. 19(1):25-41; discussion 41-4, 1999
                                                                                  16. Morgan DE et al: Pancreas divisum: implications for diagnostic and therapeutic pancreatography. AJR Am J Roentgenol. 173(1):193-8, 1999
                                                                                  17. Bret PM et al: Pancreas divisum: evaluation with MR cholangiopancreatography. Radiology. 199(1):99-103, 1996
                                                                                  18. Rizzo RJ et al: Congenital abnormalities of the pancreas and biliary tree in adults. Radiographics. 15(1):49-68; quiz 147-8, 1995