A gastric duplication cyst of the pancreas associated with a bifid tail causing pancreatitis

We herein demonstrate a case of a gastric-type duplication cyst of the pancreas with a bifid tail in a 1year-old girl, who presented as relapsing pancreatitis with pseudocyst formation. We reviewed the literature concerning pancreatic enteric duplication cysts with and without pancreatitis to search for causes of pancreatitis. The following new information was obtained: 1) The presence of a communication between the pancreatic duct system and enteric duplication cysts is the major cause, but it does not always lead to pancreatitis. 2) Enteric duplication cysts are occasionally connected to abnormal pancreatic lobes or ducts. We suggest that a duplication cyst associated with bifid pancreas is in the same category as the association of enteric cyst formation and pancreatic lobe maldevelopment. Since an aberrant lobe associated with an enteric duplication cyst often evokes pancreatitis, its surgical resection should be considered. 2013 The Authors. Published by Elsevier Inc. Open access under CC BY license. Enteric duplication cysts are tubular or cystic structures which normally lie alongside the gastrointestinal tract. Enteric duplication cysts occur anywhere near the gastrointestinal tract from the neck to rectum, but their presentation within the pancreas is rare [1]. The symptoms of pancreatic duplication cysts include abdominal pain, nausea, vomiting, and incidental abdominal mass [1]. Bifid pancreas is an aberrant branching anomaly of the main pancreatic duct, showing a Y-shaped pancreatic tail [2]. The pancreas develops from two distinct embryological origins: the ventral and dorsal pancreatic buds. It has been suggested that a bifid pancreas develops from a bifid dorsal pancreatic duct, and it is generally thought that the bifid pancreas itself does not cause pancreatic diseases [2]. Pancreatitis and pseudocysts due to a congenital etiology are uncommon. We reviewed the literature to search for the mechanism by which pancreatic enteric duplication cysts might cause