Pancreas divisum in pancreaticobiliary maljunction in children.
OBJECTIVE
Pancreaticobiliary maljunction (PBM) is defined as a congenital anomaly in which the main pancreatic and common bile ducts are joined outside the duodenal wall and forms the long common channel. Although PBM and pancreas divisum are congenital anomalies causing pancreatitides, distinct data about the incidence of pancreas divisum in pediatric PBM has not been reported to date. The present study was designed to reveal the incidence and clinical features of pancreas divisum in cases of PBM.


METHODS
The configurations of pancreatic ducts of 78 pediatric cases of PBM were assessed by endoscopic retrograde cholangiopancreatography (ERCP) and/or intraoperative cholangiopancreatography. Additional cannulation of the minor papilla was performed when the entire length of the main pancreatic duct was not detected with cannulation of the major papilla alone.


RESULTS
Clear pancreatography was obtained in 71 cases out of 78 cases of PBM. Abnormal fusion of the pancreatic duct was detected in 1 case (1.4%) with complete pancreas divisum. This case was asymptomatic preoperatively and for 10 years postoperatively.


CONCLUSIONS
Pancreas divisum exists in 1.4% of PBM. Although pancreas divisum is one of the pathogenesis of pancreatitis in PBM, is rarely associated with PBM and not always causes pancreatitis.
Terui
Keita
K
Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chiba, 260-8677, Japan. kta@cc.rim.or.jp
Hishiki
Tomoro
T
Saito
Takeshi
T
Sato
Yoshiharu
Y
Takenouchi
Ayako
A
Saito
Eriko
E
Ono
Sachie
S
Kamata
Toshiko
T
Yoshida
Hideo
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003135:Common Bile Duct / Q000002:abnormalities* / Q000000981:diagnostic imaging; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010179:Pancreas / Q000002:abnormalities* / Q000000981:diagnostic imaging; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000453:epidemiology