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Review
. 2011 Apr;13(2):150-6.
doi: 10.1007/s11894-010-0170-8.

Pancreas divisum

Matthew J DiMagno  1 , Erik-Jan Wamsteker
Affiliations
Review

Pancreas divisum

Matthew J DiMagno et al. Curr Gastroenterol Rep. 2011 Apr.

Abstract

We review important new clinical observations in pancreas divisum (PD) made since 2007. PD is common and has the same prevalence in the general population and idiopathic pancreatitis (IP). Up to 53% of patients with PD and IP have underlying idiopathic chronic pancreatitis (CP), and in rigorous prospective clinical follow-up and/or natural history studies, many with idiopathic recurrent acute pancreatitis (IRAP) have idiopathic CP. According to retrospective studies, PD does not modify the natural course of nonalcoholic or alcoholic CP. CFTR and/or SPINK1 gene mutations associate with IP (idiopathic CP and IRAP) independently of the presence of PD. More than one third of patients with pancreatitis or presumed pancreaticobiliary pain respond to placebo. Authors of uncontrolled studies report a significant symptomatic response to surgery and endotherapy in patients with IP and PD, but the response remains unproven and is largely limited to those with IRAP and not idiopathic CP or chronic pain.

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Conflict of interest statement

Conflicts of interest: M. DiMagno—none; E-J. Wamsteker—none.

Figures

Figure 1
Figure 1
(A) The prevalence of pancreas divisum (PD) without or with pancreatitis reported in autopsy, endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and secretin-MRCP (S-MRCP) studies. (B) The prevalence of PD with acute and chronic pancreatitis reported in ERCP and S-MRCP studies. Bars represent mean PD as percent of total cases (n) and error bars are 95% confidence intervals. Figure adapted from ref [1•]. Permission from Lippincott Williams & Wilkins.
See this image and copyright information in PMC

References

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