Introduction. Pancreas divisum is a relatively common pancreatic duct
anatomic variant, firstly described in the 17th century. Case report. We
reported a 2-year-old child admitted to the Pediatric Clinic with breathing
difficulties and abdominal pains. Examination and X-ray image, showed a vast
right hydrothorax containing rusty coloured solution with a high degree of
amylase. Ultrasound and computed tomography examination revealed pancreatic
polycyclic pseudocysts; following magnetic resonance cholangiopancreatography
(MRCP), the diagnosis of pancreas divisum was confirmed. The general
condition of the patient worsened, requiring an urgent operation. External
drainage of the perforated pancreatic pseudocyst was performed. Following
external fistula maturation, a change from external to internal drainage was
performed using Roux-en-Y fistulojejunostomy. A 3-year postoperative period
was uneventful. Conclusion. Pancreas divisum cases are unique requiring
clinical experience, rational approach, and complex multimodal management.
MRCP is a valuable diagnostic method. Amongst therapeutic options, outer and
internal drainage can be seen as reliable methods. Further investigations are
absolutely required to determine practical and appropriate conclusions.
Successful cruciate incision of the minor papilla in a patient with acute pancreatitis due to pancreas divisum: A case report
