Table 1.

Comparison of imaging techniques for the diagnosis and management of pancreas divisum

Technique	Role	Limitations
Endoscopic retrograde cholangiopancreatography	Allows investigation and management of the condition in the same setting10	Irritation of the pancreas during endoscopy may cause pancreatitis Relative contraindications include coagulopathies and anticoagulation therapy
Abdominal computed tomography	Useful for the evaluation of pancreatic glandular anatomy and other causes of pancreatitis May allow visualization of the ductal anatomy	Exposure of the patient to radiation
Magnetic resonance cholangiopancreatography	Allows noninvasive investigation of the condition	Cost and availability of magnetic resonance imaging scanners General limitations, including morbid obesity, claustrophobia and the presence of metallic foreign bodies Exposure of the patient to radiation Endoscopic retrograde cholangiopancreatography is still required for management
Transabdominal ultrasonography	Generally not useful in making the diagnosis May be of some use for evaluating pancreatic glandular anatomy and other causes of pancreatitis Secretin-stimulated ultrasound* can identify anomalous ductal paths	Efficacy is limited by patient’s body fat, positioning and bowel location
Endoscopic ultrasonography	Allows endoscopic investigation of pancreatic anatomy by use of an ultrasound probe	Irritation of the pancreas during endoscopy may cause pancreatitis

^*Sequential measurement of pancreatic duct size following intravenous administration of secretin.