Duggal Shivangini, Akahara Ozioma, Didia Claudia
Internal Medicine, Texas Tech University of Health Sciences, El Paso, USA.
Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA.
Cureus. 2025 Apr 15;17(4):e82313. doi: 10.7759/cureus.82313. eCollection 2025 Apr.
Pancreas divisum, resulting from incomplete fusion of the pancreatic ducts during development, disrupts normal drainage and can lead to recurrent acute and chronic pancreatitis. This report presents a case of a 46-year-old male with chronic necrotizing pancreatitis secondary to pancreas divisum. The patient experienced multiple hospital admissions and underwent a cholecystectomy before the underlying etiology, pancreas divisum, was identified after six hospitalizations. This case highlights the diagnostic challenges of recurrent pancreatitis, emphasizing the importance of considering congenital pancreatic anomalies in patients with unexplained or refractory disease. It also underscores the need for a systematic approach to evaluating recurrent pancreatitis to avoid delays in diagnosis and unnecessary interventions. Pancreas divisum is associated with recurrent pancreatitis in a subset of patients. While endoscopic retrograde cholangiopancreatography remains the gold standard for diagnosis and intervention, non-invasive imaging such as magnetic resonance cholangiopancreatography is preferred for initial diagnosis. Endoscopic treatment, including minor papilla papillotomy and stenting, is typically effective for symptomatic cases. However, surgery may be necessary when these methods fail.
胰腺分裂是由于发育过程中胰管融合不完全所致，它会破坏正常引流，并可能导致复发性急性和慢性胰腺炎。本报告介绍了一例46岁男性患者，其患有继发于胰腺分裂的慢性坏死性胰腺炎。该患者多次住院，在进行胆囊切除术后，经过六次住院才确定潜在病因——胰腺分裂。该病例突出了复发性胰腺炎的诊断挑战，强调了对于不明原因或难治性疾病患者考虑先天性胰腺异常的重要性。它还强调了对复发性胰腺炎进行系统评估的必要性，以避免诊断延误和不必要的干预。胰腺分裂在一部分患者中与复发性胰腺炎相关。虽然内镜逆行胰胆管造影术仍然是诊断和干预的金标准，但对于初始诊断，磁共振胰胆管造影等非侵入性成像更为可取。内镜治疗，包括小乳头切开术和支架置入术，通常对有症状的病例有效。然而，当这些方法失败时可能需要手术。
