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Pancreatic Divisum

Pancreatic divisum, a common congenital duct variation, can trigger abdominal pain or recurrent pancreatitis when symptomatic. At Houston's GastroDoxs, Dr. Scott combines expert imaging, personalized care plans, and minimally invasive treatments to provide relief and optimal digestive wellness for patients.

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Scott Liu

About the Expert

Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.

What Is Pancreatic Divisum?

Pancreatic divisum is a congenital condition where the ducts of the pancreas fail to fuse during fetal development. As a result, digestive enzymes drain through a smaller duct, which can cause backup and inflammation. While many individuals have no symptoms, some may experience recurrent abdominal pain or pancreatitis. Diagnosis is often made using MRCP (Magnetic Resonance Cholangiopancreatography) or ERCP (Endoscopic Retrograde Cholangiopancreatography). Treatment options depend on symptoms and may include endoscopic therapy to improve drainage or surgical intervention in severe cases.

Common Causes and Risk Factors

  • Congenital ductal anomaly-failure of the pancreatic ducts to fuse in utero
  • Presence of two separate pancreatic drainage pathways instead of one
  • Occasional familial occurrence (rare genetic predisposition)
  • Association with recurrent bouts of acute pancreatitis
  • No link to diet, lifestyle, or external illness

Signs and Symptoms

  • Often asymptomatic-many never know they have it
  • Intermittent upper abdominal pain or discomfort
  • Pain that may flare after eating, especially fatty meals
  • Nausea, vomiting, or early satiety
  • Recurrent pancreatitis-painful inflammation of the pancreas

How Dr. Scott Diagnoses Pancreatic Divisum?

Dr. Scott uses a step-by-step approach:

Medical History and Physical Exam

He reviews your epigastric pain patterns, prior episodes of pancreatitis, family history, alcohol use and other risk factors.

Blood Tests

We check serum amylase and lipase levels to detect pancreatic inflammation and rule out other causes of abdominal pain.

Imaging Studies

  • MRI with MRCP - noninvasive mapping of the pancreatic ducts to spot a divisum.
  • Endoscopic ultrasound (EUS) - high-resolution images of duct anatomy and surrounding tissue.
  • ERCP - direct visualization and the option to intervene therapeutically in the same session.

Advanced Testing (if needed)

During ERCP, Dr. Scott can perform a minor papilla sphincterotomy or place a temporary stent to confirm ductal drainage and relieve obstruction.

Dr. Scott at GastroDoxs
Treatment

Our Team offers a full range of care for pancreatic divisum.

1. Lifestyle and Diet Modifications

  • Eat smaller, low-fat meals to ease pancreatic workload
  • Stay well hydrated to support digestive enzyme flow
  • Avoid alcohol and smoking to reduce inflammation risk

2. Medications

  • Pain management tailored to your symptoms
  • Pancreatic enzyme supplements to aid digestion
  • Anti-inflammatory drugs when needed to control pancreatitis

3. Minimally Invasive or Advanced Procedures

  • ERCP (Endoscopic Retrograde Cholangiopancreatography) to open or dilate narrowed ducts
  • Stent placement for improved pancreatic fluid drainage
  • Rarely, surgical intervention if endoscopic therapies are not effective
Scott Liu

About the Expert

Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.

Frequently Asked Questions

What is pancreatic divisum?

Pancreatic divisum is a congenital condition where the pancreas drains through two ducts instead of one main duct.

Can this condition lead to cancer?

Pancreatic divisum itself does not directly cause cancer, but repeated inflammation (pancreatitis) may increase long‐term risks.

Are the symptoms serious?

Many people have no symptoms. Some experience mild upper‐abdominal pain or fullness after eating, while a few develop severe pancreatitis.

What is the ICD-10 code for pancreatic divisum?

The medical code for pancreatic divisum is Q45.8.

Is surgery required?

Most patients do not need surgery. Many find relief with diet and lifestyle changes, medications, or endoscopic treatments like ERCP with stent placement.

Is pancreatic divisum common in Houston?

This condition occurs worldwide. In Houston, Dr. Scott at GastroDoxs sees it in patients who have unexplained pancreatic pain or recurrent pancreatitis.

Where can I learn more?

Visit the National Pancreas Foundation online at www.pancreasfoundation.org for additional resources and support.

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