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Pancreatic pseudocyst in the setting of chronic pancreatitis and pancreas divisum


The leading theory regarding the pathophysiology of the association between pancreas divisum and recurrent acute pancreatitis or chronic pancreatitis is the presence of a stenotic minor papilla predisposing certain patients to outflow obstruction; this obstruction is the actual risk factor that results in a tendency for certain patients to have recurrent pancreatitis, whereas others remain asymptomatic. Response of the cystic fibrosis transmembrane regulator protein in the nasal epithelium of patients with pancreas divisum and recurrent acute pancreatitis is decreased (13 mV) compared with normal controls (22 mV), but not as low as in patients with cystic fibrosis (-1 mV in patients with sufficient pancreatic exocrine function and -3 mV in patients with pancreatic insufficiency).

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