Abstract
RATIONALE: Pancreas divisum is a congenital anatomical anomaly resulting from failure of fusion of the Santorini and Wirsung ducts during fetal development, with a prevalence of 5% to 14% in the general population. Although usually asymptomatic, it is associated with chronic and recurrent pancreatitis. PATIENT CONCERNS: A 47-year-old female presented with severe abdominal pain, diarrhea, vomiting, and signs of dehydration for several days, with a delayed diagnosis. DIAGNOSES: Magnetic resonance cholangiopancreatography showed the main pancreatic duct with a separate estuary over the collecting duct. The accessory pancreatic duct had a common outlet with the collecting duct. INTERVENTIONS: Endoscopic retrograde cholangiopancreatography with minor papilla papillotomy and double plastic stent implantation was performed. OUTCOMES: During the 1-year follow-up, the patient remained well without recurrence of pancreatitis. LESSONS: Pancreatitis due to congenital abnormalities is infrequent but should be considered when common causes are not identified.