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How is pancreas divisum diagnosed?
The most accurate test to diagnose pancreas divisum is ERCP (endoscopic retrograde cholangio-pancreatography), which can demonstrate the presence of two separately draining pancreatic ducts. However, ERCP itself sometimes can cause attacks of pancreatitis. Other tests that can help diagnose pancreas divisum without the risk of causing pancreatitis include endoscopic ultrasound (EUS), and MRI (magnetic resonance imaging).
What is the treatment for pancreas divisum?
Pancreas divisum without symptoms needs no treatment. Treatment of patients with abdominal pain and recurrent pancreatitis attributable to pancreas divisum has not been well established. Some doctors will attempt sphincterotomy (cutting of the minor papilla during ERCP to enlarge its opening). Others will insert a stent during ERCP into the duct to prevent duct blockage. These procedures are not risk free. Therefore, patients with symptomatic pancreas divisum are best evaluated and treated by doctors in centers experienced in treating pancreatic diseases.
What is the prognosis for pancreas divisum?
Most patients with pancreas divisum remain asymptomatic and therefore the prognosis is excellent. For those patients with symptoms of pancreatitis, the prognosis is no different than that of the unaffected population who develop pancreatitis. Even after treatment, pancreatitis may recur. It is important to remember that there is no clear evidence to support a causal relationship between pancreas divisum and pancreatitis.
Medically reviewed by John A. Daller, MD; American Board of Surgery
REFERENCE: MedscapeReference.com. Pancreas Divisum.
Previous contributing author: Dennis Lee, MD.