Ultrasound images Congenital anomalies of the pancreas
The normal pancreas is the result of the fusion of two embryonic buds: the ventral bud arises from the CBD, forming the uncinate process and part
of the head, and the dorsal arises from the posterior wall of the duodenum. Developmental anomalies of the pancreas occur as a result of a failure
of the dorsal and ventral pancreatic ducts to fuse, that is pancreas divisum. This arrangement may cause inadequate drainage of the pancreatic duct,
leading to pancreatitis. A rare developmental anomaly of the ventral bud may occur, pancreas annulare, in which pancreatic tissue encircles the
bowel. In this latter case, patients can present with proximal small-bowel obstruction in infancy, but this may also be an incidental finding at
autopsy. These relatively uncommon anomalies cannot usually be diagnosed on ultrasound.
Increasingly, magnetic resonance cholangiopancreatography (MRCP) is replacing ERCP in the evaluation of the pancreas and ductal system, due
to its relative non-invasive nature and low risk compared with ERCP. Agenesis of the pancreas is very rare, usually in association with other defects, and children usually die soon after birth.
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