Ansa Pancreatica, an Uncommon Cause of Acute, Recurrent Pancreatitis

Overview

Journal Case Rep Gastroenterol

Publisher Karger

Specialty Gastroenterology

Date 2021 Oct 7

PMID 34616260

Citations 3

Authors

Danial H Shaikh

Ahmed Alemam

Jennifer von Ende

Haider Ghazanfar

Anil Dev

Bhavna Balar

Affiliations

Soon will be listed here.

Abstract

The pancreatic duct is vulnerable to developmental anomalies which may produce variations in its course and/or its configuration. Ansa pancreatica is the least common anatomic variant. It is characterized by the formation of an "S-shaped loop" from the main pancreatic duct to the minor papilla. Ansa pancreatica has been implicated as a cause of recurrent acute pancreatitis. We review existing literature on pancreatitis secondary to the ansa deformity and present a case of recurrent acute pancreatitis in a patient who was ultimately found to have the ansa deformity on endoscopic ultrasound.

Citing Articles

Ansa pancreatica: A rare etiology behind acute pancreatitis: Features and management.

Neirouz K, Mohamed H, Aziz A, Rania O, Lassaad G, Hafedh M Int J Surg Case Rep. 2024; 123:110244.

PMID: 39303485 PMC: 11437751. DOI: 10.1016/j.ijscr.2024.110244.

Ansa Pancreatica: A Rare Culprit in Recurrent Acute Pancreatitis.

Goyal M, Vuthaluru A, Taranikanti V Cureus. 2024; 16(4):e59235.

PMID: 38813275 PMC: 11133233. DOI: 10.7759/cureus.59235.

Endoscopic Ultrasound in Pancreatic Duct Anomalies.

Chatterjee A, Rana S Diagnostics (Basel). 2023; 13(19).

PMID: 37835872 PMC: 10572994. DOI: 10.3390/diagnostics13193129.

References

Gandhi V, Gautam P, Pai N . Recurrent acute pancreatitis and the reverse 'S'-shaped pancreatic duct. BMJ Case Rep. 2019; 12(6). PMC: 6557347. DOI: 10.1136/bcr-2018-226492. View

Carrascosa-Miron T, Leon-Ledesma R, Manuel-Vazquez A, Gorosabel-Calzada M . Uncommon anatomic variation of the pancreatic duct: ansa pancreatica. Cir Esp (Engl Ed). 2019; 98(4):236. DOI: 10.1016/j.ciresp.2019.04.019. View

Harbi H, Toumi N, Ben Amar M . Acute Pancreatitis Due to a Rare Ductal Anomaly: Ansa Pancreatica. Am J Med Sci. 2019; 357(1):e1. DOI: 10.1016/j.amjms.2018.09.001. View

Ishii H, Arai K, Fukushima M, Maruoka Y, Hoshino M, Nakamura A . Fusion variations of pancreatic ducts in patients with anomalous arrangement of pancreaticobiliary ductal system. J Hepatobiliary Pancreat Surg. 1999; 5(3):327-32. DOI: 10.1007/s005340050054. View

Magulick J, Salem R, Jamidar P . Intraoperative pancreatoscopy for surgical planning in a patient with ansa pancreatica and mixed-type intraductal pancreatic mucinous neoplasm. Gastrointest Endosc. 2020; 92(4):968-970. DOI: 10.1016/j.gie.2020.04.052. View

Ayari H, Rebii S, Ayari M, Hasni R, Zoghlami A . [Ansa pancreatica: a rare cause of acute pancreatitis]. Pan Afr Med J. 2013; 13:33. PMC: 3542784. View

Lee S, Davidson C, Kia Y, Devereaux B, Godinho S, Appleyard M . Recurrent pancreatitis in the setting of gallbladder agenesis, ansa pancreatica, Santorinicoele and eventual intraductal papillary mucinous neoplasia (IPMN). Ann Hepatobiliary Pancreat Surg. 2020; 24(3):381-387. PMC: 7452808. DOI: 10.14701/ahbps.2020.24.3.381. View

Tanaka T, Ichiba Y, Miura Y, Itoh H, Dohi K . Variations of the pancreatic ducts as a cause of chronic alcoholic pancreatitis; ansa pancreatica. Am J Gastroenterol. 1992; 87(6):806. View

Adibelli Z, Adatepe M, Imamoglu C, Esen O, Erkan N, Yildirim M . Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients. Radiol Oncol. 2016; 50(4):370-377. PMC: 5120578. DOI: 10.1515/raon-2016-0041. View

10.

Lopez-Duran S, Zaera C, Gonzalez-Martin J, Foruny J, Albillos A, Vazquez-Sequeiros E . The endoscopic ultrasound-assisted Rendez-Vous technique for treatment of recurrent pancreatitis due to pancreas divisum and ansa pancreatica. Rev Esp Enferm Dig. 2017; 109(11):798-800. DOI: 10.17235/reed.2017.4949/2017. View

11.

Hussain S, Malik M, Khan S . Case report on Ansa Pancreatica: An Uncommon Cause Accounting for Recurrent Pancreatitis in Children. J Pak Med Assoc. 2019; 69(11):1759-1761. DOI: 10.5455/JPMA.29846.. View

12.

Takuma K, Kamisawa T, Hara S, Tabata T, Kuruma S, Chiba K . Etiology of recurrent acute pancreatitis, with special emphasis on pancreaticobiliary malformation. Adv Med Sci. 2012; 57(2):244-50. DOI: 10.2478/v10039-012-0041-7. View

13.

Dawson W, LANGMAN J . An anatomical-radiological study on the pancreatic duct pattern in man. Anat Rec. 1961; 139:59-68. DOI: 10.1002/ar.1091390109. View

14.

Hayashi T, Gonoi W, Yoshikawa T, Hayashi N, Ohtomo K . Ansa pancreatica as a predisposing factor for recurrent acute pancreatitis. World J Gastroenterol. 2016; 22(40):8940-8948. PMC: 5083799. DOI: 10.3748/wjg.v22.i40.8940. View

15.

Bhasin D, Rana S, Nanda M, Gupta R, Nagi B, Wig J . Ansa pancreatica type of ductal anatomy in a patient with idiopathic acute pancreatitis. JOP. 2006; 7(3):315-20. View

16.

Giarraputo L, Savastano S, Napetti S . Trifidum anomaly of the main pancreatic duct. Pancreatology. 2020; 20(3):569-570. DOI: 10.1016/j.pan.2020.01.018. View

17.

Turkvatan A, Erden A, Turkoglu M, Yener O . Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol. 2013; 14(6):905-13. PMC: 3835637. DOI: 10.3348/kjr.2013.14.6.905. View

18.

Jagielski M, Smoczynski M, Drelich-Goreczna B, Adrych K . Transduodenal drainage of symptomatic walled-off pancreatic necrosis in a patient with ansa pancreatica anatomic variation. Arch Med Sci. 2017; 13(1):267-269. PMC: 5206381. DOI: 10.5114/aoms.2017.64724. View

19.

Jarrar M, Khenissi A, Ghrissi R, Hamila F, Letaief R . Ansa pancreatica: an anatomic variation and a rare cause of acute pancreatitis. Surg Radiol Anat. 2013; 35(8):745-8. DOI: 10.1007/s00276-013-1103-7. View

20.

Tabata T, Kamisawa T, Takuma K, Anjiki H, Egawa N . A patent accessory pancreatic duct prevents pancreatitis following endoscopic retrograde cholangiopancreatography. Dig Surg. 2010; 27(2):140-3. DOI: 10.1159/000286962. View