Pancreatographic investigation of embryology of complete and incomplete pancreas divisum.
OBJECTIVE
To investigate embryology of complete and incomplete pancreas divisum (PD).


METHODS
We analyzed anatomy of the pancreatic duct system in 44 cases of complete PD and 41 cases of incomplete PD. Under the concept of branch fusion between the ventral and dorsal pancreatic ducts, incomplete PD was divided into 3 types: fusion of the extreme end of the upper branch of the ventral pancreatic duct with the dorsal pancreatic duct (type 1); fusion of the lower branch of the dorsal pancreatic duct with the lower branch of the ventral pancreatic duct (type 2); and fusion of the lower branch of the dorsal pancreatic duct with the ventral pancreatic duct (type 3).


RESULTS
Complete PD showing no ventral pancreatic duct radiologically might be induced by complete regression of the ventral pancreatic duct near the orifice in the pancreas with communication between the ventral and dorsal pancreatic ducts. Embryological mechanism of incomplete PD (type 1, n = 16; type 2, n = 10; and type 3, n = 15) was confirmed by measurement in pancreatograms.


CONCLUSIONS
Some cases of complete PD might be induced by complete regression of the ventral pancreatic duct near the orifice. Embryology of incomplete PD can be accounted by concept of branch fusion.
Kamisawa
Terumi
T
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. kamisawa@cick.jp
Egawa
Naoto
N
Tu
Yuyang
Y
Tsuruta
Kouji
K
Okamoto
Atsutake
A
D002760:Cholangiopancreatography, Endoscopic Retrograde; D006801:Humans; D010179:Pancreas / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000473:pathology; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000473:pathology; D010191:Pancreatic Polypeptide / Q000378:metabolism
D010191:Pancreatic Polypeptide