Pancreas divisum

Pancreatic divisum

Pancreas divisum is a birth defect in which parts of the pancreas do not join together. The pancreas is a long, flat organ located between the stomach and spine. It helps in food digestion.

Causes

Pancreas divisum is the most common birth defect of the pancreas. In many cases, this defect goes undetected and causes no problems. The cause of the defect is unknown.

As a baby develops in the womb (uterus), two separate pieces of tissue join together to form the pancreas. Each part has a tube, called a duct. When the parts join together, a final duct, called the pancreatic duct, is formed. Fluid and digestive juices (enzymes) produced by the pancreas normally flow through this duct.

Pancreas divisum occurs if the ducts do not join while the baby develops. Fluid from the two parts of the pancreas drains into separate areas of the upper portion of the small intestine (duodenum). This occurs in 5% to 15% of people.

If a pancreatic duct becomes blocked, swelling and tissue damage (pancreatitis) may develop.

Symptoms

Many people do not have any symptoms. If you have pancreatitis, symptoms include:

Abdominal pain, most often in the upper abdomen that may be felt in the back
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
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Abdominal swelling (distention)
Abdominal swelling
A swollen abdomen is when your belly area is bigger than usual.
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Nausea or vomiting

Exams and Tests

You may have the following tests:

Abdominal ultrasound
Abdominal ultrasound
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, pancreas, and kidneys...
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Abdominal CT scan
Abdominal CT scan
An abdominal CT scan is an imaging test that uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomography....
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Amylase and lipase blood tests
Amylase
Amylase is an enzyme that helps digest carbohydrates. It is made primarily in the pancreas and the glands that make saliva, and can be found at low ...
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Lipase
Lipase is a protein (enzyme) released by the pancreas into the small intestine. It helps the body absorb fat. This test is used to measure the amou...
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Endoscopic retrograde cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreat...
ERCP is short for endoscopic retrograde cholangiopancreatography. It is a procedure that looks at the bile and pancreatic ducts. It is done through...
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Magnetic resonance cholangiopancreatography (MRCP)
Endoscopic ultrasound (EUS)
Endoscopic ultrasound
Endoscopic ultrasound is a type of imaging test. It is used to see organs in and near the digestive tract.
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Treatment

The following treatments may be needed if you have symptoms of the condition, or if pancreatitis keeps returning:

ERCP with a cut to enlarge the opening where the pancreatic duct drains
Placement of a stent to prevent the duct from getting blocked

You may need surgery if these treatments do not work.

Outlook (Prognosis)

Most of the time the outcome is good.

Possible Complications

The main complication of pancreas divisum is pancreatitis.

When to Contact a Medical Professional

Contact your health care provider if you develop symptoms of this disorder.

Prevention

Because this condition is present at birth, there is no known way to prevent it.

Open References

References

Adams DB, Coté GA. Pancreas: Pancreas divisum and other variants of dominant dorsal duct anatomy. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:549-556.

Kumar V, Abbas AK, Aster JC, Deyrup AT, Das A. Pancreas. In: Kumar V, Abbas AK, Aster JC, Deyrup AT, Das A, eds. Robbins & Kumar Basic Pathology. 11th ed. Philadelphia, PA: Elsevier; 2023:chap 15.

Mehta MS, Barth BA, Husain SZ. Anatomy, histology, embryology and developmental anomalies of the pancreas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 55.

Pancreas divisum - illustration
Pancreas divisum is the most common birth defect of the pancreas. The pancreas is an organ that helps in food digestion by producing digestive juices (enzymes) that drain into the intestine through a tube (duct). While the baby is developing inside the uterus, two separate parts of the pancreas come together to form the pancreas and the two ducts join. In pancreas divisum, the two ducts are separate and drainage may be impaired.
Pancreas divisum
illustration
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted through the large intestine.
Digestive system
illustration
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Pancreas - illustration
The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.
Pancreas
illustration

Pancreas divisum - illustration
Pancreas divisum is the most common birth defect of the pancreas. The pancreas is an organ that helps in food digestion by producing digestive juices (enzymes) that drain into the intestine through a tube (duct). While the baby is developing inside the uterus, two separate parts of the pancreas come together to form the pancreas and the two ducts join. In pancreas divisum, the two ducts are separate and drainage may be impaired.
Pancreas divisum
illustration
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted through the large intestine.
Digestive system
illustration
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Pancreas - illustration
The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.
Pancreas
illustration

A Closer Look

Self Care

Tests for Pancreas divisum

Review Date: 10/20/2025

Reviewed By: Todd Eisner, MD, Private practice specializing in Gastroenterology in Boca Raton and Delray Beach, Florida at Gastroenterology Consultants of Boca Raton. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Pancreas divisum

Causes

Symptoms

Abdominal pain

Abdominal swelling

Exams and Tests

Abdominal ultrasound

Abdominal CT scan

Amylase

Lipase

Endoscopic retrograde cholangiopancreat...

Endoscopic ultrasound

Treatment

Outlook (Prognosis)

Possible Complications

When to Contact a Medical Professional

Prevention

References

Pancreas divisum - illustration

Pancreas divisum

Digestive system - illustration

Digestive system

Endocrine glands - illustration

Endocrine glands

Pancreas - illustration

Pancreas

Pancreas divisum - illustration

Pancreas divisum

Digestive system - illustration

Digestive system

Endocrine glands - illustration

Endocrine glands

Pancreas - illustration

Pancreas

A Closer Look

Self Care

Tests for Pancreas divisum

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