Newspaper article St Louis Post-Dispatch (MO)

Fetus Development `Glitch' Leads to Pancreas Divisum

Newspaper article St Louis Post-Dispatch (MO)

Fetus Development `Glitch' Leads to Pancreas Divisum

Article excerpt

Dear Dr. Donohue: I was born with pancreas divisum. My pancreas failed to develop normally. I am 29, female and am on Pancrease. I have pains. I'm afraid of surgery. Can you help me understand?

Pancreas divisum is an example of how a glitch can occur as a fetus develops. Most such glitches are minor and easily overcome, others bode health consequences in later life.

Yours, unchecked, is one of the latter. During fetal life, the pancreas, an important digestive-enzyme source, starts out divided, with a separate duct serving each half. In normal development, the halves fuse, the twin ducts merging as one. Thus are we born fully prepared for the digestive challenges of life. For 10 percent of us, duct fusion fails to occur, leaving a single pancreas with two ducts. Most people with pancreas divisum get along fine, while others experience chronic organ inflammation and pain. Your medicine supplies enzymes that the digestive system is not getting. Two painful factors might prompt surgery: The two ducts are on the small side and easily blocked, with important pancreatic enzymes failing to get to the digestive system. Or, more importantly, enzymes remain behind to "digest" organ tissue. Surgery's aim would be to enlarge the twin drainage ducts. It all might sound awesome, but modern techniques make it much less so. Surgery, in fact, offers a good chance of living reasonably well with serious pancreas divisum. Without it, there might lie the dire prospect of life as a digestive cripple. Dear Dr. Donohue: When chickenpox immunization becomes available, will it protect senior citizens against shingles? As I understand it, the same virus is involved. Your perceptive question is on many minds. There is no definite answer. With shingles, we are dealing with a reawakening of the old chickenpox virus, which went into nerve-cell seclusion after the childhood illness. …

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