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Annular pancreas
Definition
An annular pancreas is a ring of pancreatic tissue that encircles the duodenum (the first part of the small intestine). Normally, the pancreas sits next to, but does not surround the duodenum.
Causes, incidence, and risk factors
Annular pancreas is a congenital defect, which means it is present at birth. Symptoms occur when the ring of pancreas squeezes and narrows the small intestine so that food cannot pass easily or at all.
Newborns may have symptoms of complete blockage of the intestine. However, up to half of people with this condition do not have symptoms until adulthood. There are also cases that are not detected because the symptoms are mild.
Conditions that may be associated with annular pancreas include:
- Down syndrome
- Other congenital gastrointestinal problems
- Pancreatitis
- Excessive amniotic fluid during pregnancy (polyhydramnios)
Symptoms
Newborns may not tolerate feedings. They may spit up more than normal, not drink enough breast milk or formula, and cry.
Adult symptoms may include:
- Fullness after eating
- Nausea or vomiting
Signs and tests
Tests include:
Treatment
Surgical bypass of the blocked part of the duodenum is the usual treatment for this disorder.
Expectations (prognosis)
The outcome is usually good with surgery.
Complications
- Obstructive jaundice
- Pancreatitis (inflammation of the pancreas)
- Peptic ulcer
- Perforation (tearing a hole) of the intestine due to obstruction
- Peritonitis
Calling your health care provider
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 duodenum. 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; and 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.
