Pancreas divisum is a congenital defect wherein the parts of the pancreas don’t fuse together. Scroll down to know more on the symptoms of pancreas divisum and the viability of surgery as a pancreas divisum treatment option.
Pancreas is a elongated glandular organ that is positioned at the back of the stomach, and stretches across the rear part of the abdominal cavity. This elongated tapering organ is divided into head, neck, body, tail and uncinate process. The broad part of pancreas lying to its right is referred to as the head, while the tapering section that ends around the spleen, is referred to as the tail. The neck is a constricted portion of the pancreas that connects the body of the pancreas to the head. Uncinate process is a hook-like prolongation of the head of the pancreas.
Pancreas secretes hormones and enzymes that play a vital role in the process of digestion and other metabolic processes. While unhealthy dietary habits and other poor lifestyle choices we make, can make us susceptible to pancreatitis (inflamed pancreas), at times, pancreas function may be adversely affected due to congenital structural defects. Pancreas divisum is one such congenital anomaly wherein the two ducts that fuse to form the pancreatic duct are unable to join in the mother’s womb. In this article, we will find out more about the signs of pancreas divisum along with pancreas divisum treatment options.
Symptoms of Pancreas Divisum
Before we move on to treatment options for pancreas divisum, let’s get a basic idea about the fetal pancreatic development. The pancreas develops from foregut, which is an outgrowth of the small intestine. Two pancreatic buds or ducts form in the initial phase of the development of the pancreas. These are referred to as the ventral duct and the dorsal duct. These two ducts fuse in order to form the main pancreatic duct.
The pancreatic duct and the common bile duct join at the ampulla of Vater, and their secretions then flow into the small intestine at the major duodenal papilla. In case of individuals affected by pancreas divisum, the pancreatic secretions that flow through the ventral duct drain into the major duodenal papilla, while the contents of the dorsal duct drain into the minor papilla.
It is believed that in majority of individuals affected by this congenital defect, most of the secretions flow from the dorsal duct and drain into the minor papilla. So, what are the repercussions of this congenital defect on one’s health? Well, an individual who has been diagnosed with pancreas divisum may or may not experience any symptoms. Asymptomatic pancreas divisum is not really a cause of any serious concern, however, treatment would be required if one experiences pancreatic pain.
Abdominal pain, abdominal distension, nausea or vomiting are some of the symptoms that may be exhibited by the sufferer. Though there isn’t enough evidence on the exact cause and the link between pancreas divisum and inflammation of the pancreas, it is believed that the secretions may back up into the dorsal duct, if the minor duodenal papilla is too narrow. This may make one susceptible to recurring bouts of pancreatitis.
Diagnosis and Treatment of Pancreas Divisum
A physical examination may not really provide the doctors the information necessary for formulating a diagnosis which is why doctors usually order certain diagnostic tests. As far as the blood work is concerned, the patient’s blood sample would be tested for the levels of pancreatic enzymes such as lipase and amylase.
An abdominal CT scan or an abdominal ultrasound are some of the useful diagnostic tools that would help the doctors view the pancreas. Endoscopic retrograde cholangiopancreatography (ERCP) and Magnetic resonance cholangiopancreatography (MRCP) are other imaging procedures that can certainly help the doctors diagnose the underlying cause of inflammation of the pancreas or other pancreas problems that one may have suffering from.
Doctors may recommend surgery or other treatment options if the congenital anomaly starts interfering with the pancreas function. For instance, surgery may be recommended if the imaging procedures reveal narrowing of the minor papilla in case of a patient suffering from recurring bouts of pancreatitis. Endoscopic stenting or sphincterotomy are surgical procedures that may be used for the treatment of pancreas divisum.
Under these procedures, the minor papilla may be cut open so as to enlarge its opening, thereby facilitating the flow of pancreatic secretions into the duodenum. At times, the doctors may place a stent into the duct so as to prevent the duct from getting clogged. However, these surgical procedures are believed to pose certain health risks. Certain complications may occur as a result of these procedures. For instance, in case of patients where multiple stents have been placed over a period of time, trauma to the ducts or other anatomical features could give rise to inflammation.
Since surgery is believed to make one susceptible to pancreatitis, doubts have been raised on the efficacy of surgery as a treatment option for pancreas divisum. Thus, surgery is resorted to only if the symptoms are very severe. Pancreas is a compound gland that works in a dual capacity, by secreting digestive enzymes as well as hormones such as insulin and glucagon. Thus, severe health problems can arise if anatomical defects or other conditions adversely affect the pancreas function. Thus, individuals who have been experiencing symptoms that indicate malfunctioning of the pancreas must get themselves medically examined.
