Annular pancreas

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Annular pancreas
Diagram of the pancreas
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Vomiting, feeding intolerance, abdominal pain
Complications	Duodenal obstruction, pancreatitis
Onset	Neonatal or adult
Duration	Long-term
Types	N/A
Causes	Congenital disorder
Risks	Polyhydramnios, Down syndrome, Trisomy 18
Diagnosis	Ultrasound, CT scan, MRI
Differential diagnosis	Duodenal atresia, malrotation, pancreatic cancer
Prevention	N/A
Treatment	Surgery (e.g., duodenojejunostomy)
Medication	Proton pump inhibitors, antiemetics
Prognosis	Generally good with treatment
Frequency	Rare
Deaths	N/A

An annular pancreas is a rare congenital condition in which a ring of pancreatic tissue encircles the duodenum, the first part of the small intestine. This ring of tissue can constrict the duodenum, potentially leading to obstruction.

Anatomy and Development

The pancreas is a glandular organ located in the abdomen, with both exocrine and endocrine functions. During normal embryological development, the pancreas forms from the fusion of the dorsal and ventral pancreatic buds. In the case of an annular pancreas, the ventral bud fails to rotate properly, resulting in a ring of pancreatic tissue that surrounds the duodenum.

Clinical Presentation

Symptoms of an annular pancreas can vary depending on the degree of duodenal obstruction. In newborns, it may present as duodenal atresia or stenosis, leading to bilious vomiting shortly after birth. In adults, symptoms may include abdominal pain, nausea, vomiting, and signs of peptic ulcer disease.

Diagnosis

Diagnosis of an annular pancreas is typically made using imaging studies. Upper gastrointestinal series and computed tomography (CT) scans can reveal the characteristic "double bubble" sign or the presence of a ring of pancreatic tissue around the duodenum.

Treatment

Treatment of an annular pancreas depends on the severity of the symptoms. In cases of significant obstruction, surgical intervention may be necessary. The most common surgical procedure is a duodenojejunostomy, which bypasses the obstructed segment of the duodenum.

Related Pages

• Pancreas
• Duodenum
• Congenital disorder
• Digestive system