Endoscopic treatment of disconnected pancreatic duct syndrome secondary to acute necrotizing pancreatitis in a patient with pancreas divisum.

Abstract

A 50-year old male with acute necrotizing pancreatitis had an unfavorable evolution in the third week of disease, with development of large volume ascites and walled-off necrosis affecting the head and body of pancreas, suspected to be infected, with viable parenchyma in the tail of pancreas. Endoscopic ultrasound guided drainage of the collection was performed through placement of a lumen apposing metal stent. Selective cannulation of main pancreatic duct was only possible though the minor papilla and after contrast media injection a type 1 pancreas divisum and partial disruption of dorsal pancreatic duct were diagnosed.