Journal List > J Korean Endocr Soc > v.25(1) > 1003543

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Kim, Park, Kim, Ko, Lee, Lee, Shin, Kim, and Kim: A Case of Complete Agenesis of the Dorsal Pancreas in a Patient with Newly Diagnosed Diabetes Mellitus
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2010; 25(1): 78-83.

Published online: 31 March 2010

DOI: https://doi.org/10.3803/jkes.2010.25.1.78

A Case of Complete Agenesis of the Dorsal Pancreas in a Patient with Newly Diagnosed Diabetes Mellitus

Dong Pil Kim, Kang Seo Park, Dong Sun Kim, Bong Suk Ko, Ji Hae Lee, Jae Hyuk Lee, Jong Ho Shin, Byung Jun Kim1, Hyun Jin Kim

Department of Internal Medicine, Eulji University College of Medicine, Korea.

1Department of Internal Medicine, Konyang University College of Medicine, Korea.

Received 18 May 2009       Accepted 12 October 2009

Copyright © 2010 Korean Endocrine Society

Abstract

Agenesis of the dorsal pancreas is a rare congenital anomaly caused by underdevelopment or agenesis of the dorsal pancreatic bud that forms the upper head, neck, body and tail of the pancreas. We report a case of agenesis of the dorsal pancreas, which was found under examination of diabetes mellitus (DM). A 16-year-old girl was transferred to our hospital because of a positive urine glucose reading during a school-conducted examination. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed the deficit of the pancreatic body and tail. Diabetes-associated autoimmune antibodies were negative in a blood test. Decreased β-cell function was demonstrated by oral glucose tolerance and glucagon stimulation tests. Although the notion that agenesis of the dorsal pancreas leads to decreased endocrine or exocrine function is controversial, the results of this study suggest that we should consider these causes of diabetes mellitus. When treating a young patient with diabetes mellitus, we should consider causes of diabetes mellitus such as congenital anomaly or maturity onset diabetes, in addition to type 1 and type 2 diabetes mellitus.

Keywords: Agenesis of dorsal pancreas, Diabetes mellitus, Insulin

Figures and Tables

Fig. 1
Pedigree of the patient reveals that there is no family history of diabetes mellitus.
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Fig. 2
Abdominal CT scan shows (A) normal pancreatic head without abnormal calcification or ductal dilatation (arrow), and (B) nonvisualization of pancreatic body and tail at the level of splenic vein (arrow).
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Fig. 3
Magnetic resonance cholangiopancreatography (MRCP). A. T2-weighted image shows normal pancreatic duct in pancreas head. B. In maximum intensity projection image, pancreatic duct of body and tail and Santorini duct cannot be seen.
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Table 1
75 g oral glucose tolerance test after 6 month of insulin treatment
jkes-25-78-i001

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