Dorsal pancreatic agenesis: a case report

Abstract

The pancreas develops from a small ventral bud and a larger dorsal bud. During the rotation of the foregut, the ventral pancreas rotates toward the dorsal pancreas and joins together to form a complete pancreas with ducts. Among the various developmental congenital anomalies, dorsal pancreatic agenesis is one of the rare entities, with less than a hundred cases reported so far. It involves the absence of the dorsal bud derivatives (head, body, and tail).

Case presentation: Herein, we present a case of a 50-year-old woman who presented to general outpatient department with a complaint of abdominal pain. The patient was diagnosed with cholelithiasis with a contrast-enhanced computed tomography finding of dorsal pancreatic agenesis on a detailed workup. However, the patient did not have any other associated anomalies or symptoms associated with dorsal pancreatic agenesis. The patient was managed for cholelithiasis with laparoscopic cholecystectomy.

Clinical discussion: Failure in development due to aberrant embryogenesis may cause partial or complete agenesis of the dorsal pancreas. The minor papilla, the accessory pancreatic duct, the body, and the tail of the pancreas are not present in the case of complete dorsal agenesis. Most cases of dorsal pancreatic agenesis are asymptomatic and diagnosed incidentally, whereas some of the cases may present with other associated abnormalities. It is almost always diagnosed via imaging modalities.

Conclusion: Dorsal pancreatic agenesis is a very rare congenital anomaly of the pancreas. It can be diagnosed via various imaging modalities and almost always remains a radiological diagnosis with incidental findings.

Keywords: agenesis; contrast-enhanced computed tomography; pancreas.

Figure 1

Magnetic resonance cholangiopancreatography image showing the pancreatic duct only in the uncinate process and in a part of the head of the pancreas (white arrow) with no visualization of the duct of the remaining head, body, and tail.

Figure 2

Axial contrast-enhanced computed tomography scan showing an uncinate process and a part of the head of the pancreas (red arrow) with no visualization of the remaining head, body, and tail.

Figure 3

Coronal contrast-enhanced computed tomography showing an uncinate process and a part of the head of the pancreas (red arrow) with no visualization of the remaining head, body, and tail.