A CASE OF PANCREAS DIVISUM COMPLICATED WITH PANCREATIC CANCER

Abstract

A case of pancreas divisum complicated with pancreatic cancer was reported. The patient is 75-year-old female. She has been treated for diabetes mellitus for 7 years with good control. Recently, she began to complain of equivocal abdominal pain and weight loss and was found to have increased level of fast blood sugar. Moreover, rigid mass about 5 cm in diameter was palpated in her epigastrium. ERCP showed no communication between Wirsung's duct and Santorini's duct. Furthermore, ERCP revealed that the ventral pancreatic system was found normal appearance but the dorsal pancreatic duct was interrupted in site of 5 cm apart from accessory papilla orifice. From this finding, carcinoma in the dorsal pancreas was diagnosed. She underwent non curative operation. She died about 6 months after the operation. These findings of ERCP completely consisted with pancreatogram at autopy. Histological findings of pancreas tumor showed poorly differentiated adenocarcinoma. This carcinoma widely invased beyond the capsule of pancreas. On the other hand, carcinoma was not found in the ventral pancreas. Therefore, it was persumed that carcinoma arised from dorsal pancreas. It might be recommended that it should be made an effort to obtain dorsal pancreatogram, because pancreas divisum might be complicated with pancreatic cancer such as our present case.