title: Pancreas divisum: analysis and therapeutic alternatives with a case report.
abstract: BACKGROUND
  Pancreas divisum is a relatively common pancreatic duct anatomic variant, firstly described in the 17th century.
  
  
  METHODS
  We reported a 2-year-old child admitted to the Pediatric Clinic with breathing difficulties and abdominal pains. Examination and X-ray image, showed a vast right hydrothorax containing rusty coloured solution with a high degree of amylase. Ultrasound and computed tomography examination revealed pancreatic polycyclic pseudocysts; following magnetic resonance cholangiopancreatography (MRCP), the diagnosis of pancreas divisum was confirmed. The general condition of the patient worsened, requiring an urgent operation. External drainage of the perforated pancreatic pseudocyst was performed. Following external fistula maturation, a change from external to internal drainage was performed using Roux-en-Y fistulojejunostomy. A 3-year postoperative period was uneventful.
  
  
  CONCLUSIONS
  Pancreas divisum cases are unique requiring clinical experience, rational approach, and complex multimodal management. MRCP is a valuable diagnostic method. Amongst therapeutic options, outer and internal drainage can be seen as reliable methods. Further investigations are absolutely required to determine practical and appropriate conclusions.
authors.affiliation: Clinic of Pediatric Surgery, Institute for Child and Youth Health Care of Vojvodina, Clinical Center Vojvodina, Novi Sad, Serbia. jokic.rs@gmail.com
authors.forename: Radoica
authors.initials: R
authors.lastname: Jokić
authors.forename: Pavle
authors.initials: P
authors.lastname: Milosević
authors.forename: Georgios
authors.initials: G
authors.lastname: Konstantinidis
authors.forename: Jovan
authors.initials: J
authors.lastname: Vlaski
authors.forename: Miroslav
authors.initials: M
authors.lastname: Beserminji
mesh_terms: D002675:Child, Preschool; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010179:Pancreas / Q000002:abnormalities* / Q000000981:diagnostic imaging; D010192:Pancreatic Pseudocyst / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography