Does Pancreas divisum have any determinant role in acute pancreatitis?

Abstract

Purpose:

Pancreatic developmental anomalies are a spectrum of anatomical variations, including the pancreas divisum, where its association with acute pancreatitis continues being controversial.

Materials and methods:

Firstly, a non-experimental cross-sectional study was carried out on one hundred cadaveric duodenpancreatic pieces, and secondly was analyzed the case report of a patient with extrahepatic cholestasis and acute pancreatitis associated with pancreas divisum. The objective was to determinate the prevalence of the decompressive pancreatic system.

Results:

There is a statistically significant difference between the dimensions of the accessory pancreatic duct and its relation with the permeability. In terms of pancreatic volumetry, the section corresponding to the upper third cephalic, neck, body and tail of the organ registers an average dimension of 21.99 cm3, while the section of the last two thirds cephalic was 8.17 cm3. Simultaneously, the patient reported presented a pancreatitis with amylase 280 UI/l, lipase 173 UI/l, associated with cholestasis. On the second day of hospitalization, endoscopic retrograde cholangiopancreatography was performed with a greater duodenal papillotomy and extraction of multiple common bile duct stones, evidencing a complete pancreas divisum.

Discussion:

The exposed case shows that pancreatitis, in presence of pancreas divisum, would have the denomination of a subclinical ventral pancreatitis.

Conclusion:

The pancreas divisum would be a predictor of acute pancreatitis by losing the decompressive pancreatic protective mechanism.