Fusion Anomalies of the Pancreatic Ductal System: Differentiation from Pathologic States

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Abstract
If fusion of the ventral and dorsal pancreatic ducts does not occur during fetal life, endoscopic retrograde cannulation of the papilla of Vater may visualize a small complete ductal system which is confined to the head of the pancreas. This system is characterized by normal arborizations throughout, relatively small duct diameters and the absence of a communication with the minor papilla. If fusion took place and the ductal system is shortened by disease, pancreatography in patients may demonstrate abrupt proximal termination or proximal tapering without side branches and may show a significant duct of Santorini. If the ducts fused, an area of narrowing approximately 3-20 mm in length commonly occurs at the level of fusion. This should not be confused with pathologic ductal stenosis.

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