Chronic pancreatitis and congenital strictures of the pancreatic duct

Abstract

Chronic pancreatitis may occasionally be due to chronic incomplete obstruction of the pancreatic duct. Pancreas divisum is associated with a high incidence of recurrent pancreatitis or pancreatic pain, which may be due to relative stenosis of the accessory papilla through which most of the pancreatic secretions drain. Stenosis of the pancreatic duct at the site of fusion of the ventral and dorsal ducts has been demonstrated in 3 percent of autopsy subjects and in patients studied with ERCP. Two patients with idiopathic chronic pancreatitis presented with dilatation of the pancreatic duct which extended distally from the site of fusion of the embryonic ducts. We postulate that congenital stenosis of the main pancreatic duct may predispose to chronic pancreatitis in the absence of other obvious etiologic factors.