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Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 21-29

Imaging of pancreas divisum by linear-array endoscopic ultrasonography

1 Department of Gastroenterology, Jaswant Rai Speciality Hospital, Meerut, India
2 Department of Anatomy, Muzaffarnagar Medical College, Muzaffarnagar, India
3 Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute (SGPGI), Lucknow, Uttar Pradesh, India

Correspondence Address:
Malay Sharma
Department of Gastroenterology, Jaswant Rai Speciality Hospital, Meerut - 250 001, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2303-9027.175878

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Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. Endoscopic ultrasound (EUS) is often performed to evaluate idiopathic pancreatitis and has been shown to have high accuracy in diagnosis of PD. The different techniques to identify PD by linear EUS have been described differently by different authors. If EUS is done with a proper technique it can be a valuable tool in the diagnosis of PD. The anatomical and technical background of different signs has not been described so far. This article summarizes the different techniques of imaging of pancreatic duct in a suspected case of PD and gives a technical explanation of various signs. The common signs seen during evaluation of pancreatic duct in PD are stack sign of linear EUS, crossed duct sign on linear EUS, the dominant duct and ventral dorsal duct (VD) transition. Few other signs are described which include duct above duct, short ventral duct /absent ventral duct, separate opening of ducts with no communication, separate opening of ducts with filamentous communication, stacking of duct of Santorini and indirect signs like santorinecele. The principles of the sign have been explained on an anatomical basis and the techniques and the principles described in the review will be helpful in technical evaluation of PD during EUS.

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