Pancreas divisum versus complete obstruction of the main pancreatic duct

What pancreatographic features distinguish pancreas divisum from complete obstruction of the main pancreatic duct? 

Although the main duct opacified via the major papilla is shorter than normal in both conditions, their pancreatographic appearances are usually distinctive.

  • • With obstruction, the main duct appears truncated. Caliber of the opacified part of the main duct and its branches is normal, and upstream termination of the main duct is abrupt. Two other conditions—traumatic disruption of the main duct and excision of the pancreatic tail and body—can have this same appearance.
  • • In divisum, the ductal system appears minified. Caliber of the main duct is small, and the main duct terminates upstream not abruptly but by branching and tapering.
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