title: Disruption of both dorsal and ventral ducts in a patient with pancreas divisum presenting with two pseudocysts.
abstract: A 35-year-old man, a chronic alcohol consumer with clinical features of acute pancreatitis, presented with obstructive jaundice and melena. On radiological evaluation two large pseudocysts, one each in relation to pancreatic head and tail regions, were noted with a gastro-duodenal artery pseudoaneurysm in the pseudocyst in the head region. He also had narrowing of the common bile duct. On endoscopic retrograde cholangiopancreatography (ERCP) he had evidence of chronic pancreatitis with morphology of pancreas divisum with disruption of both the dorsal and ventral ducts. After the relieving of bile duct obstruction with endoscopically placed stent, he underwent surgery for the pseudoaneurysm and the two pseudocysts. The case highlights the rare occurrence of both dorsal and ventral ductal disruption in a patient with pancreas divisum. ERCP was helpful in providing the diagnosis and guiding further management.
authors.affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Manphool
authors.initials: M
authors.lastname: Singhal
authors.affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Lal
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. dr_kochhar@hotmail.com.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kochhar
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Usha
authors.initials: U
authors.lastname: Dutta
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Birinder
authors.initials: B
authors.lastname: Nagi
authors.affiliation: Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Jai Dev
authors.initials: JD
authors.lastname: Wig
authors.affiliation: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Kartar
authors.initials: K
authors.lastname: Singh
keywords: Ductal disruption; Pancreas divisum; Pseudoaneurysm; Pseudocyst