Pancreas divisum

  • Commonest congenital pancreatic abnormality
  • Failure of normal fusion of dorsal and ventral anlage 
  • Dorsal and ventral ducts don’t fuse
  • Wirsung (ventral duct) drains head of pancreas via major papilla
  • Santorini (dorsal duct) drains body and tail via minor papilla
  • Can cause functional stenosis of minor papilla and secondary pancreatitis
  • Higher prevalence in patients with recurrent or chronic pancreatitis. Etiology is not the divisum, but rather the genetic mutations associated with divisum causing recurrent inflammation
  • MRCP best for visualization of ducts