1. Congenital anomalies

Question 1

Types of congenital anomalies

Answer 1

1. Agenesis of the pancreas
2. Pancreas divisum
3. Annular pancreas
4. Ectopic pancreas

Question 2

Agenesis of the pancreas

Answer 2

1. Absence of development of the pancreas

2. Incompatible with life

Question 3

Pancreas divisum

Answer 3

1. Most common congenital anomaly of the pancreas (3-10%)
2. Due to failure of fusion of the fetal pancreatic duct systems of the dorsal & ventral pancreatic primordia
   - Normally, distal dorsal duct joins to the proximal ventral duct to form the main pancreatic duct (duct of Wirsung) which drains the bulk of the pancreatic secretions into the duodenum through the major duodenal papilla
   - In pancreas divisum, lack of this fusion results in a very short duct of Wirsung (ventral duct without connection to the dorsal duct)
   - Majority of pancreas then drains through the minor pancreatic duct (duct of Santorini) into the duodenum through the minor duodenal papilla
3. Pathological effects & complications:
   - Chronic pancreatitis

Question 4

Annular pancreas

Answer 4

1. Band-like ring of normal pancreatic tissue that completely encircles the 2nd part of the duodenum
2. Pathological effects & complications:
   - Duodenal obstruction (leading to gastric distension & vomiting)

Question 5

Ectopic pancreas

Answer 5

1. Aberrantly situated pancreatic tissue usually found in stomach, duodenum, jejunum, Meckel diverticula & ileum
2. Pathological effects & complications:
   - Localized inflammation (pain, bleeding)
   - Ectopic pancreatic endocrine neoplasms may arise