학술논문

The Epidemiology and Clinical Presentation of Pancreatic Divisum: A Case Series of 57 Case Reports.
Document Type
Article
Source
Southern Medical Journal. Mar2024, Vol. 117 Issue 3, p159-164. 6p.
Subject
*PANCREAS divisum
*SYMPTOMS
*CLINICAL epidemiology
*ENDOSCOPIC retrograde cholangiopancreatography
*PANCREATIC duct
Language
ISSN
0038-4348
Abstract
Pancreatic divisum (PD) is the most common congenital abnormality of the pancreatic duct. It can be associated with complications such as pancreatitis or pancreatitis-like pain. This article provides cumulative data of 57 case reports of PD and highlights the statistical findings of the most common presentations, diagnostic methods, treatment options, and associated complications. The goal of the article was to provide a comprehensive picture of clinical and epidemiological methods of diagnosis and treatment of PD. Objectives: Pancreatic divisum (PD) is the second most common congenital abnormality of the pancreatic duct, which affects 2% to 3% of the population. Most of the population remains asymptomatic, but in people who present with symptoms, it can be a cause of anguish and should be recognized. The main goal of this article was to provide a comprehensive picture of clinical and epidemiological methods of diagnosis and treatment of PD. Methods: A total of 57 PD case reports were considered in this descriptive analysis with 51 case reports and case series published within the last 25 years. The search strategies include systemic searches using scholarly search engines such as Medscape, Scopus, Cochrane, and PubMed. Results: The 57 cases we studied have an average age of presentation of 42 years, with female sex (58%) predominance. Common presenting symptoms were abdominal pain (87.72%) and radiation to the back (21.6%). Eighty-one percent of the case studies reported pancreatitis, and 63.2% had recurrent pancreatitis. At presentation, laboratory values demonstrated increased amylase, lipase, and liver enzymes. PD was diagnosed using magnetic resonance cholangiopancreatography (28.1%), endoscopic retrograde cholangiopancreatography (57.9%), endoscopic ultrasound (7%), or computed tomography (5.3%) scan of the abdomen. Of significance, biliary duct dilation was found in 70.6% of patients diagnosed as having PD. Incidental masses were found in 66.7% of the patients. The most successful treatment was sphincterotomy with or without stents (47.6%), followed by pancreatoduodenectomy (19%) and pancreaticojejunostomy (10%). Conclusions: Physicians managing pancreatitis should add PD to their differential diagnoses because it will help improve patient outcomes and avoid unfavorable consequences. [ABSTRACT FROM AUTHOR]