Anatomical Variations of Pancreas Divisum in Magnetic Resonance Cholangiopancreatography: A Cross-sectional Study

Abstract

Introduction: Pancreas divisum is the most common congenital anomaly of the pancreas. It occurs due to failure of fusion of the dorsal and ventral pancreatic buds in the 7th week of intrauterine life, and leads to the formation of a large dorsal pancreatic duct and a small ventral pancreatic duct. Different types of pancreas divisum had been reported in the literature due to varying patterns of fusion of the dorsal and ventral pancreatic ducts. Aim: The present study had been performed to find out the anatomical variations of pancreas divisum, pancreatic ducts and associated congenital anomalies. Materials and Methods: The present cross-sectional retrospective study was carried out in the Department of Radiology, Gauhati Medical College and Hospital, Guwahati, Assam from January 2022 to March 2023. The Magnetic Resonance Cholangiopancreatography (MRCP) plates of 159 patients were collected and studied for variations of pancreas divisum, pancreatic ducts and associated congenital anomalies. Results: In the present study, 34 (29.8%) cases had Type-1 (classical), 5 (4.4%) cases had Type-2 and 75 (65.9%) cases had Type-3 pancreas divisum. Also, 105 (66.03%) cases had Type-1 pancreatic duct and 34 (21.4%) cases had Type-4 pancreatic duct. Four (21%) cases had associated Komi Type- 2A, a choledochal cyst. Conclusion: In the present study, Type-3 pancreas divisum was most common. Also, most cases had Type-1 Major Pancreatic Duct (MPD). Choledochal cysts were found to be mostly associated with pancreas divisum.