Embryology: pancreas divisum: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Embryology: pancreas divisum

Sample item

A 32-year-old man has recurrent idiopathic acute pancreatitis. MRCP shows the dorsal duct draining most of the gland through the minor papilla, with a small ventral duct. Which embryological failure explains this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Failure of the ventral and dorsal pancreatic duct systems to fuse

Normally the ventral bud rotates behind the duodenum and fuses with the dorsal bud, and the ventral duct joins the distal dorsal duct to form the main duct that opens at the major papilla. In pancreas divisum the two duct systems do not fuse, so the larger dorsal portion drains through the small minor papilla. Relative obstruction may cause recurrent pancreatitis.

Option by option

  • A. Failure of the dorsal pancreatic bud to develop

    Failure of the dorsal bud would remove the body and tail, and the dorsal duct would be absent.

  • B. Failure of the ventral bud to rotate with the bile duct

    The ventral bud rotates with the bile duct normally, and failure of rotation is not the explanation for the duct arrangement.

  • C. Failure of the ventral and dorsal pancreatic duct systems to fuse (correct)

    Correct. Nonfusion of the two duct systems leaves the dorsal duct draining through the minor papilla.

  • D. Abnormal migration of the ventral bud around both sides of the duodenum

    Abnormal migration of the ventral bud around the duodenum produces annular pancreas with duodenal obstruction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Failure of the ventral and dorsal pancreatic duct systems to fuse. Normally the ventral bud rotates behind the duodenum and fuses with the dorsal bud, and the ventral duct joins the distal dorsal duct to form the main duct that opens at the major papilla.

Why is "Failure of the dorsal pancreatic bud to develop" not the answer?

Failure of the dorsal bud would remove the body and tail, and the dorsal duct would be absent.

Why is "Failure of the ventral bud to rotate with the bile duct" not the answer?

The ventral bud rotates with the bile duct normally, and failure of rotation is not the explanation for the duct arrangement.

Why is "Abnormal migration of the ventral bud around both sides of the duoden…" not the answer?

Abnormal migration of the ventral bud around the duodenum produces annular pancreas with duodenal obstruction.

What concept does this question test?

It tests Embryology: pancreas divisum in Anatomy. In pancreas divisum the two duct systems do not fuse, so the larger dorsal portion drains through the small minor papilla. Relative obstruction may cause recurrent pancreatitis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Embryology: pancreas divisum?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.