Annular pancreas
Definition
An annular pancreas is a ring of pancreatic tissue that encircles the duodenum (the first part of the small intestine, just below the stomach).
Causes
Annular pancreas is caused by malformation during the development of the pancreas, before birth. This condition may result in a narrowing of the duodenum due to squeezing by the ring of pancreas.
Complete obstruction of the duodenum is often seen in newborns with this condition. However, half of cases are not diagnosed until symptoms occur in adulthood. There are probably many cases that go undetected due to mild symptoms.
People with this condition are more like to have a peptic ulcer.
Symptoms
- Feeding intolerance in newborns
- Fullness after eating
- Nausea and vomiting
Exams and Tests
Signs that may indicate annular pancreas include:
- Down syndrome
- Other congenital (something you are born with) gastrointestinal problems
- Pancreatitis
- Excessive amniotic fluid during pregnancy (polyhydramnios)
Tests include:
Treatment
Surgical bypass of the blocked part of the duodenum is the usual treatment for this disorder.
Outlook (Prognosis)
The outcome is usually good with surgery.
Possible Complications
- Obstructive jaundice
- Pancreatitis (inflammation of the pancreas)
- Peptic ulcer
- Perforation (tearing) of the intestine due to obstruction
- Peritonitis
When to Contact a Medical Professional
Call for an appointment with your health care provider if you or your child have any symptoms of annular pancreas.
References
Russo MA, Redel CA. Anatomy, histology, embryology, and developmental anomalies of the stomach and duodeum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 45.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
