Type 3-Pancreatic Divisum presenting as Recurrent AbdominalPain

Abstract

A previously well 8-year-old girl presented with recurrent bouts of upper abdominal pain mostly post-prandial in nature. She was seen on multiple occasions
with recurrent episodes of the same and was treated as “Acute gastritis “with multiple courses of Proton pump inhibitors (PPI). Her response to the pain was short lived and re-occurred frequently only to be prescribed again with another course of PPI’s.
Her evaluation by the paediatric gastroenterologist showed a Complete blood count, Liver function tests, Serum Amylase and Lipase were all within normal limits. Upper Gastrointestinal Endoscopy revealed a normal mucosa up to the 2nd part of Duodenum and her biopsy of the Oesophagus, antrum and Duodenum were all normal.
Her upper Gastrointestinal Endoscopy revealed two ducts of Pancreas which indicated the likelihood of a probable pancreatic divisum. The child underwent a MRCP (Magnetic resonance cholangiopancreatography) which revealed a filamentous accessory pancreatic duct and a Main pancreatic duct which confirmed the diagnosis of Type 3 pancreatic divisum. She was prescribed oral pancreatic supplements and is being followed up for monitoring her growth and prevention of recurrence.