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Disruption of both dorsal and ventral ducts in a patient with pancreas divisum presenting with two pseudocysts

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Abstract

A 35-year-old man, a chronic alcohol consumer with clinical features of acute pancreatitis, presented with obstructive jaundice and melena. On radiological evaluation two large pseudocysts, one each in relation to pancreatic head and tail regions, were noted with a gastro-duodenal artery pseudoaneurysm in the pseudocyst in the head region. He also had narrowing of the common bile duct. On endoscopic retrograde cholangiopancreatography (ERCP) he had evidence of chronic pancreatitis with morphology of pancreas divisum with disruption of both the dorsal and ventral ducts. After the relieving of bile duct obstruction with endoscopically placed stent, he underwent surgery for the pseudoaneurysm and the two pseudocysts. The case highlights the rare occurrence of both dorsal and ventral ductal disruption in a patient with pancreas divisum. ERCP was helpful in providing the diagnosis and guiding further management.

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Acknowledgments

The authors wish to thank Mr. Vijay Kant Bakshi, Department of Anatomy, for art work and Ms. Poonam Sharma, Department of Radiodiagnosis, for preparation of the manuscript.

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Authors and Affiliations

  1. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Manphool Singhal & Anupam Lal

  2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Rakesh Kochhar, Usha Dutta, Birinder Nagi & Kartar Singh

  3. Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Jai Dev Wig

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  1. Manphool Singhal
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  2. Anupam Lal
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  3. Rakesh Kochhar
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  4. Usha Dutta
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  5. Birinder Nagi
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  6. Jai Dev Wig
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  7. Kartar Singh
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Correspondence to Rakesh Kochhar.

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Singhal, M., Lal, A., Kochhar, R. et al. Disruption of both dorsal and ventral ducts in a patient with pancreas divisum presenting with two pseudocysts. Clin J Gastroenterol 2, 115–118 (2009). https://doi.org/10.1007/s12328-008-0050-z

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  • DOI: https://doi.org/10.1007/s12328-008-0050-z

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