About Pancreatic Divisum
Pancreatic divisum is a congenital condition (a condition present from birth) that happens during fetal development. Normally, the pancreas starts as two separate parts, each with its own duct (a tube that carries digestive juices). As the embryo grows, these two parts usually join to form one duct. However, in pancreas divisum, this joining does not happen, and the pancreas keeps two separate ducts. This can affect how digestive juices flow from the pancreas to the small intestine.
Pancreatic divisum is present from birth. Most people with pancreas divisum do not have any symptoms and live normal lives. However, some people may develop symptoms such as repeated episodes of acute pancreatitis (sudden inflammation or the pancreas) or chronic pancreatitis (long-term inflammation). For those with symptoms, treatment options may include medication or surgery, depending on how serious the symptoms are. It is important to talk with a healthcare professional to get the right diagnosis and treatment.
Most people with pancreatic divisum do not have symptoms. For people who do experience symptoms, common symptoms include:
- Abdominal (stomach) pain
- Bloating (swollen or full feeling in the stomach)
- Jaundice: Yellowing of the skin and eyes
- Nausea
- Food intolerance (having trouble digesting certain foods)
- Repeated episodes of pancreatitis (inflammation of the pancreas)
It's important to know that not everyone with pancreatic divisum will experience symptoms, and in some cases, the condition is only discovered during other medical care. If you are experiencing any of these symptoms or have concerns about pancreatic divisum, it's best to talk with a healthcare professional for the right diagnosis and treatment. They can provide personalized advice and suggest tests or treatments if needed.
Pancreatic divisum may be diagnosed using the following exams, tests, and procedures:
- Medical history and physical exam: A healthcare provider will gather information about symptoms and medical history and perform a physical exam to look for signs such as:
- Abdominal pain: They may press on your abdomen to check for tenderness or pain, especially if you’ve been having stomach discomfort
- Signs of pancreatitis: Since pancreas divisum can sometimes cause pancreatitis, they will check for symptoms like, swelling, pain, or jaundice.
- Lab tests: There are no specific lab tests that directly diagnose pancreas divisum. Blood tests may be done to rule out other conditions or problems with the pancreas or liver.
- Pancreatic enzymes: These blood tests check for high levels of pancreatic enzymes, like amylase or lipase, which can show inflammation of the pancreas.
- Liver function tests: These blood tests can help find any issues with the bile ducts, which may be related to pancreas divisium.
- Imaging studies: Depending on the symptoms and physical exam results, imaging studies like X-rays or magnetic resonance imaging (MRIs) may be done to get a closer look at the condition.
- Magnetic resonance cholangiopancreatography (MRCP): This is a method that doesn’t require surgery and uses a strong magnetic field and radio waves to create detailed images of the pancreas and its ducts. It doesn’t use x-rays and can help find whether there are two separate pancreatic ducts instead of one joined duct.
- Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure involves passing a flexible tube with a tiny camera through the mouth into the stomach and small intestine. X-rays are taken after putting in a special dye to view the pancreatic system. ERCP can provide detailed images of the pancreatic ducts. This procedure can help confirm a diagnosis and is done by specialized healthcare professionals.
Remember that these are general descriptions and individual recommendations may be different. It's important to talk with your healthcare professional for personalized advice about exams, tests, and procedures used to diagnose and assess pancreatic divisum.
The goals of treatment for pancreatic divisum are to control symptoms and prevent problems. Here are the different treatment options and how they work towards achieving these goals:
Medications:
- Pain medications may be prescribed to help control abdominal pain linked with pancreatic divisum. These medications work by reducing inflammation and blocking pain signals.
- Digestive enzyme supplements may be prescribed to help improve digestion and alleviate symptoms such as abdominal pain and diarrhea.
Therapeutic procedures:
- Endoscopic retrograde cholangiopancreatography (ERCP): This procedure uses an endoscope (thin, flexible tube with a camera) to reach the pancreatic duct. It can help relieve blockages or narrowed areas by widening the duct opening or inserting small tubes (stents) to keep it open.
- Sphincterotomy: In this procedure, the muscle at the opening of the pancreatic duct is cut to allow better drainage of digestive juices.
- Pancreatic duct stenting: A small tube (stent) is placed in the pancreatic duct to keep it open and improve the flow of digestive juices.
- Puestow procedure: This surgery creates a connection between the pancreatic duct and the small intestine to improve the flow of digestive juices.
- Gallbladder removal: In some cases, surgery to remove of the gallbladder may be recommended to relieve symptoms.
Self-care and health behavior changes:
- Dietary changes: Avoiding fatty or greasy foods, alcohol, and spicy foods may help reduce symptoms.
- Stop smoking: Quitting smoking can improve pancreatic health and reduce symptoms.
It's important to talk with a healthcare professional who can check your condition and suggest the right treatment for you.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.