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Pancreas Divisum - Types, Causes, and Treatments

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Pancreas divisum is a condition in which parts of the pancreas do not join. Read the article to know more about the pancreas divisum.

Written by

Dr. P. Saranya

Medically reviewed by

Dr. Vasavada Bhavin Bhupendra

Published At December 7, 2022
Reviewed AtJune 27, 2023


The pancreas is a long, flat organ behind the stomach and small intestine that secretes digestive enzymes and regulates blood sugar. A pancreas divisum is a birth defect in which parts of the pancreas do not join together. Pancreas divisum is a widespread condition affecting 5 to 10 percent of the general population. Pancreas divisum is the most common congenital anomaly of the pancreas and the most common anatomic variation of the pancreatic duct system.

What Are the Types of Pancreas Divisum?

The pancreas divisum is divided into complete and incomplete pancreas divisum. Complete pancreas divisum is the complete separation of the pancreatic duct system. An incomplete pancreas divisum has inadequate communication between the ventral and dorsal pancreatic ducts, usually an extremely small branch.

What Is the Cause of Pancreas Divisum?

The cause of the defect is unknown. In many cases, the defect goes unnoticed and causes no problems. Pancreas divisum is hereditary. The human embryo begins life with two pancreatic ducts: the dorsal and ventral. Normally, the two ducts fuse to form one main pancreatic duct. Fluid and digestive juices pass through this pancreatic duct.

When they do not fuse during embryogenic development at approximately eight weeks of intrauterine life, it results in pancreas divisum. The digestive juices and enzymes drain into the small intestine through the ventral duct and the major papilla. In the pancreas divisum, they drain through the dorsal duct and visa the minor papilla. Fluids from two parts of the pancreas drain separately.

What Are the Symptoms of Pancreas Divisum?

Most individuals born with pancreas divisum will not have any symptoms, and most cases of pancreas divisum are discovered after death during autopsy. The symptoms are due to pancreatitis and not due to pancreas divisum alone.

Some symptoms of pancreas divisum include:

  • Abdominal pain, most often in the upper abdomen.

  • Nausea.

  • Vomiting.

  • Abdominal swelling.

  • Jaundice or yellowing of the skin.

  • Food intolerance.

  • Recurrent episodes of pancreatitis (inflammation of the pancreas).

  • Sometimes, the pancreas divisum is associated with abnormalities in the womb, like choledochal cysts and intestinal malrotation.

What Is the Diagnosis of Pancreas Divisum?

The following tests are done for the proper diagnosis of pancreas divisum:

  • Magnetic Resonance Cholangiopancreatography: This test uses a magnetic field and radio waves to produce clear images of the pancreas and pancreatic ducts. A contrast material is given while taking the test. It is a non-invasive procedure and does not require x-rays.

  • Endoscopic Retrograde Cholangiopancreatography: In this procedure, a long, thin, flexible tube (endoscope) is inserted through the mouth into the stomach. A dye is injected, and x-rays of the pancreatic system are taken.

In these tests, the doctors will look for two separate ducts rather than one fused duct.

Other tests used for the diagnosis of pancreas divisum are:

  • Blood Test: Amylase and lipase enzymes are elevated in the blood test when the pancreas is damaged.

  • Computed Tomography (CT) Scan: This test uses a combination of x-rays and computer images to show detailed images of the inside of the body.

  • Magnetic Resonance Imaging (MRI): They use magnetic and radio fields to create images of the organs and tissues.

  • Endoscopic Ultrasound: This procedure combines the use of sound waves and endoscopes. It is a useful diagnostic tool for the evaluation of acute pancreatitis.

If the pancreas divisum is undiagnosed, sometimes digestive juices do not drain into the intestine properly, impacting the digestive process.

How Is Pancreas Divisum Treated?

Asymptomatic patients of pancreas divisum do not require treatment. In mild cases, the treatment focuses on a low-fat diet, relieving pain, and supplementing pancreatic enzymes. If symptomatic, the doctor might do surgery to enlarge the size of the opening of the minor papilla to allow normal flow of pancreatic enzymes.

This is done in two ways:

  • Medical Sphincterotomy: It is done through endoscopy in which the minor duct is identified, and the opening is cut open.

  • Surgical Sphincterotomy: The surgeon cuts the minor papilla opening through a laser and creates a large opening for the digestive enzymes. A stent may be inserted into the duct to ensure the duct will not cause blockage.

The complications of this surgery include acute or chronic pancreatitis and, in rare cases, kidney failure or death. Many studies have investigated the association between pancreas divisum and malignancy. Some studies report a higher risk of pancreatic adenocarcinoma associated with pancreatic divisum.

What Are the Complications of Pancreas Divisum?

The major complication of the pancreas divisum is acute or recurrent pancreatitis. It occurs when the narrowed pancreatic ducts become blocked, and the digestive juices cannot drain into the small intestine. This causes pain and swelling. The pain is usually gradual and suddenly starts at the top of the belly and worsens after eating. Acute pancreatitis is treated with fluid intake, painkillers, and nutritional support.

How Can We Prevent Pancreas Divisum?

Since the condition is present at birth, there is no way to prevent pancreas divisum.

What Are the Home Remedies for Pancreas Divisum?

The national pancreas foundation has given the following lifestyle advice for people with pancreatic diseases:

  • Low-Fat Diet: Follow a low-fat diet with no more than 20 grams of fat a day.

  • Avoid Alcohol Consumption: If you have pancreatic disease, you should never drink alcohol. Alcohol causes direct injury and inflammation of the pancreas.

  • Temporary Fasting: Limiting food intake is sometimes necessary to rest the inflamed pancreas.

  • Avoid dehydration by drinking lots of water.


Pancreas divisum is an abnormality that occurs in the womb. The condition will not impact life, and many people will not even know they have this condition. Most people remain asymptomatic, and the prognosis is excellent.

Frequently Asked Questions


Can Pancreas Divisum Cause Pancreatitis?

Most people born with the pancreas divisum will not experience any symptoms. Pancreas divisum may only be discovered during autopsy in some instances. Pancreatitis is the primary danger associated with pancreas divisum. Acute or chronic pancreatitis can sometimes be linked to the pancreas divisum.


What Are the Chances of Survival With Pancreas Divisum?

The pancreas divisum is an abnormality that develops during pregnancy and cannot be avoided. However, most individuals with pancreas divisum do not exhibit any symptoms, and the condition will not affect their daily lives. The prognosis for those with symptoms of pancreatitis is the same as those without symptoms who develop pancreatitis.


Is Pancreas Divisum a Genetic Condition?

Pancreas divisum is inherited. It is a disease that comes from birth. About 10 % of people have it when they are born, meaning that about 10 % of people have it from birth. Pancreas divisum symptoms and the need for a diagnosis or treatment are extremely uncommon.


Can the Pancreas Heal Itself?

In both animals and humans, the exocrine pancreas is capable of robust and spontaneous regeneration. For example, most people with acute pancreatitis (inflammation of the pancreas) recover within a week and can leave the hospital after five to ten days. In severe cases, however, recovery can take longer due to the possibility of complications requiring additional treatment.


How Common Is Pancreas Divisum?

The most common congenital disability affecting the pancreas is the pancreas divisum. Pancreatic divisum is a condition that affects 4 to 14 percent of people. As a rule, this condition goes undetected and leads to no issues. The defect has no known cause. The pancreas comprises two pieces of tissue that join together as a baby grows inside the womb. 


What Are the Early Signs of Pancreatic Problems?

A severe, dull pain that suddenly develops around the top of the stomach is the main symptom of acute pancreatitis. This aching pain can travel along the back or below the left shoulder blade and frequently worsens over time. Drinking or eating, particularly fatty foods, may also quickly make the person feel worse. Upper abdominal pain that worsens after eating and weight loss without trying are all signs of chronic pancreatitis.


What Is the Point Where the Pancreas Joins?

The common bile duct, which transports bile from the gallbladder, is connected to the main pancreatic duct at the ampulla of Vater, where they join the duodenum. The duodenum connects the other parts of the small bowel, where food is further digested, to the large bowel (also known as the colon or large intestine), where our poop, which has been completely digested, exits the body through the anus.


How Severe Is the Pancreas Divisum?

Most people born with the pancreas divisum will not experience any symptoms. Pancreas divisum may only be discovered during autopsy in some instances. A few people will experience symptoms like abdominal pain, nausea, vomiting, and both acute and chronic pancreatitis. Painful and susceptible to malnutrition, acute or recurrent pancreatitis can occur.


Is the Pancreas Joined to Anything?

The liver, spleen, and gallbladder surround the pancreas. The pancreas' head is located on the right side of the body. The duodenum, or first section of the small intestine, is lined with this slender organ. The pancreas' tail is located on the left side of the body. A small tube known as the pancreatic duct connects the head of the pancreas on the right side of the abdomen to the duodenum, the first section of the small intestine.


How to Treat Pancreas Divisum?

Patients without symptoms who have pancreas divisum do not require treatment. The treatment of symptomatic individuals varies and is not well-established. A surgeon may attempt a sphincterotomy or Puestow procedure in which the minor papilla is cut to enlarge the opening and permit normal enzyme flow.


Is Pancreatic Divisum a Disorder?

Pancreas divisum is hereditary and a congenital condition. About 10% of people have it when they are born, meaning about 10% have it from birth. Pancreas divisum symptoms and the need for a diagnosis or treatment are extremely uncommon. The pancreas divisum rarely causes problems but can occasionally cause acute pancreatitis. If not treated effectively, acute pancreatitis can progress to kidney failure, which can cause death.
Dr. Vasavada Bhavin Bhupendra
Dr. Vasavada Bhavin Bhupendra

Surgical Gastroenterology


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