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Pancreas Divisum

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Abstract

We review important new clinical observations in pancreas divisum (PD) made since 2007. PD is common and has the same prevalence in the general population and idiopathic pancreatitis (IP). Up to 53% of patients with PD and IP have underlying idiopathic chronic pancreatitis (CP), and in rigorous prospective clinical follow-up and/or natural history studies, many with idiopathic recurrent acute pancreatitis (IRAP) have idiopathic CP. According to retrospective studies, PD does not modify the natural course of nonalcoholic or alcoholic CP. CFTR and/or SPINK1 gene mutations associate with IP (idiopathic CP and IRAP) independently of the presence of PD. More than one third of patients with pancreatitis or presumed pancreaticobiliary pain respond to placebo. Authors of uncontrolled studies report a significant symptomatic response to surgery and endotherapy in patients with IP and PD, but the response remains unproven and is largely limited to those with IRAP and not idiopathic CP or chronic pain.

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Disclosure

Conflicts of interest: M. DiMagno is supported by National Institutes of Health grants K08 DK073298 and R21 AA017271; E-J. Wamsteker—none.

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  1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan Medical School, 1150 West Medical Center Drive, Room 6520 MSRB I, Ann Arbor, MI, 48109-0682, USA

    Matthew J. DiMagno & Erik-Jan Wamsteker

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Correspondence to Matthew J. DiMagno.

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DiMagno, M.J., Wamsteker, EJ. Pancreas Divisum. Curr Gastroenterol Rep 13, 150–156 (2011). https://doi.org/10.1007/s11894-010-0170-8

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