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Avatar universal

Help with Pancreas Divisum?

I live in Ireland, Iam a 56 y/o male, overweight, non smoker, do not drink alcohol but did drink only very occasionally, mostly a glass of wine, no more.
About 2 years ago I began to experience the most intense pain in the upper right quadrant, under my ribs, sometimes extending into the shoulder and across my mid back. During these times I had no inclination to have a bowel movement but prior to the pain my BM
4 Responses
233190 tn?1278553401
MEDICAL PROFESSIONAL
Pancreas divisum is the most common congenital pancreatic anomaly, occurring in approximately 7 percent of patients.  It is estimated that less than 5 percent of patients with pancreas divisum develop pancreatic symptoms.  There is a group of patients with pancreas divisum who are subject to recurrent bouts of seemingly idiopathic pancreatitis.  60 percent of patients with pancreas divisum and otherwise unexplained abdominal pain had relief of the pain after surgical sphincteroplasty.  

Treatment of minor papilla narrowing in pancreas divisum has traditionally been approached surgically. However, similar results are being obtained in experienced centers with endoscopic approaches.

If the symptoms continue, you may want to consider a referral to a surgeon or experienced endoscopist since there is a percentage of patients who benefit from treatment of pancreas divisum.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Lehman et al.  Treatment of pancreas divisum.  UptoDate, 2003.
Avatar universal
Thank you for your response.

I did have the endo/ultrasound done by the leading specialist here in Ireland. Her findings were that only one tube from the pancreas was connected to the duodenum. There was a small length (it appeared to her)of the second tube coming out of the pancreas and re-entering it after a very short distance. She was undecided if there was any "flow" through this.

You mentioned idiopathic pancreatitis, could you oblige and explain what that means?
Is there a high risk factor involved in the ERCP?
My current surgeon has indicated that he would not be inclined to intervene surgically unless there was severe risk to life.
This is nice to know but the pain continues unabated and becomes impossible to bear, visit to ER, admission to hospital and stay there for a week getting pain relief but the "disease"(?) goes on.
From the symptoms I describe, is there any othher condition that could be involved? I accept that's like asking about the lenght of string, but please, I'm reaching desperation point. The pancreatic enzymes don't really stop the malabsorbtion and the diahra. is constant.

If any other contributors to the forum have any ideas or comments, please make them to me. If there is a surgeon, especially with experience in this area could you do me a great service and give me some comments?

Kindest regards to all,

Patrick
Ireland
Avatar universal
Thank you for your response.

I did have the endo/ultrasound done by the leading specialist here in Ireland. Her findings were that only one tube from the pancreas was connected to the duodenum. There was a small length (it appeared to her)of the second tube coming out of the pancreas and re-entering it after a very short distance. She was undecided if there was any "flow" through this.

You mentioned idiopathic pancreatitis, could you oblige and explain what that means?
Is there a high risk factor involved in the ERCP?
My current surgeon has indicated that he would not be inclined to intervene surgically unless there was severe risk to life.
This is nice to know but the pain continues unabated and becomes impossible to bear, visit to ER, admission to hospital and stay there for a week getting pain relief but the "disease"(?) goes on.
From the symptoms I describe, is there any othher condition that could be involved? I accept that's like asking about the lenght of string, but please, I'm reaching desperation point. The pancreatic enzymes don't really stop the malabsorbtion and the diahra. is constant.

If any other contributors to the forum have any ideas or comments, please make them to me. If there is a surgeon, especially with experience in this area could you do me a great service and give me some comments?

Kindest regards to all,

Patrick
Ireland
Avatar universal
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