Takako TASAKİ, Hideki ONO, Kazunari MURAKAMİ

Successful cruciate incision of the minor papilla in a patient with acute pancreatitis due to pancreas divisum: A case report

Pancreas divisum is a congenital anatomical anomaly characterized by a lack of fusion of the ventral and dorsal parts of the pancreas, which sometimes causes pancreatitis. Most cases of pancreas divisum are difficult to treat, and no established guidelines are currently available. Here we describe the case of patient with acute recurrent pancre-atitis caused by pancreas divisum who was successfully treated with cruciate sphincterotomy of the minor papilla. A 70-year-old female was admitted to our hospital due to an emergency of acute abdominal pain, which was subsequently diagnosed as acute pancreatitis caused by pancreas divisum. The patient, recalcitrant to conservative endoscopic management of minor papilla, underwent the cruciate incision of the minor papilla, which allowed drainage of the pancreatic duct. Following this intervention, the patient’s clinical condition and serum amylase level promptly improved. No recurrence was observed over a follow-up period of 48 months. Cruciate incision of the minor papilla is an effective and safe technique for minimally invasive treatment of pancreas divisum.

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