Bifurcation of the main pancreatic duct in the body of the pancreas. Two case reports and literature study of a rare anatomical variant of the pancreatic duct

Introduction: Bifurcation of the pancreatic duct is a very rare anomaly and clinical significance is not known. Literature on this topic is scarce. We present two similar case reports with bifurcation of the main pancreatic duct from the body to the tail of the pancreas. Both cases were symptomatic, one had acute pancreatitis and the other recurrent pancreatitis. In both cases the most ventral duct was aberrant as a consequence of pancreatitis.

Discussion: We performed a literature study and found 22 relevant articles containing 26 case reports, of these cases, 12 were considered asymptomatic and were found incidentally, the other 14 cases were symptomatic with signs of acute, chronic or recurrent pancreatitis. To our knowledge this is the first article with a summary of previous published data on the subject.

Conclusion: Bifurcation of the pancreatic duct seems to be a possible cause of pancreatitis, but a large group remains asymptomatic. Since diagnosis is often difficult, the incidence is probably underestimated. More attention to this anomaly is recommended. Further reports are needed to draw conclusion.

Keywords: pancreatic duct anomaly, bifurcated pancreatic duct, pancreatitis, clinical relevance.