Pancreas Divisum

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

woman with abdominal pain
abdominal pain

What is pancreatitis?

Pancreatitis is a condition characterized by inflammation of the pancreas.

  • The pancreas is an abdominal gland situated behind the stomach in the upper abdomen.
  • The main function of the pancreas is to secrete hormones and enzymes that help with digestion and regulate blood sugar (glucose) metabolism.
  • The digestive enzymes are released via the pancreatic duct into the small intestine where they are activated to help break down fats and proteins.
  • The digestive hormones (insulin and glucagon) produced by the pancreas are released into the blood stream where they help regulate blood sugar levels.
  • Pancreatitis is categorized as being either acute or chronic.

What is pancreas divisum?

  • Pancreas divisum is a common congenital anomaly (an anomaly that is present at birth) of the pancreatic duct(s).
  • The pancreas is a deep-seated organ located behind the stomach.
  • One of its functions is to produce enzymes that are important for the digestion of food in the intestine.
  • The digestive enzymes, in the form of digestive juice, drain from the pancreas via the pancreatic duct into the duodenum (the uppermost portion of the small intestine) where they aid in digesting food.

What causes pancreas divisum?

The human embryo starts life with a pancreas that is in two parts, each with its own duct; the ventral duct and the dorsal duct. The two parts of the pancreas fuse during development In most embryos, the dorsal and the ventral ducts also will fuse to form one main pancreatic duct. The main pancreatic duct will join the common bile duct (the duct that drains bile from the gallbladder and the liver) to form a common bile and pancreatic duct which drains into the duodenum through the major papilla.

In some embryos, the dorsal and the ventral ducts fail to fuse. Failure of the ventral and the dorsal pancreatic ducts to fuse is called pancreas divisum (because the pancreas is drained by two ducts). In pancreas divisum, the ventral duct drains into the major papilla, while the dorsal duct drains into a separate minor papilla.

What are pancreas divisum symptoms?

Most individuals born with pancreas divisum experience no symptoms throughout life, will remain undiagnosed, and will not require treatment. A small number of patients with pancreas divisum will experience repeated episodes of pancreatitis. Pancreatitis is an inflammation of the pancreas that can cause abdominal pain as well as more severe complications. Some patients with pancreas divisum may develop chronic abdominal pain without pancreatitis.

Doctors are not certain how pancreas divisum causes abdominal pain and pancreatitis. One theory is that the minor papilla is too narrow to adequately drain the digestive juices in the dorsal portion of the pancreas. The backup of the digestive juices elevates the pressure in the minor duct that causes abdominal pain and pancreatitis. Others believe that there must be other factors above and beyond the anatomic anomaly of pancreas divisum that predispose a certain population of patients to develop pancreatitis. Research continues in order to determine the exact relationship.

Medically Reviewed by a Doctor on 3/18/2016

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