Unusual clinical presentation of annular pancreas in the adult (original) (raw)
Related papers
Annular pancreas producing duodenal obstruction: A case report
Open Journal of Gastroenterology, 2013
Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.
Annular Pancreas Presenting With Acute Pancreatitis And Duodenal Obstruction-A Rare Case Report
Annular pancreas manifesting in adulthood is rare and presentation after the age of 60 is rarer. We discuss our experience with one case of annular pancreas which presented with recurrent acute pancreatitis and duodenal obstruction. A 60 years old male presented with abdominal pain and features of gastric outlet obstruction. As malignancy is an important differential diagnosis to be considered at this age, the radiological features consistent with annular pancreas (CT &MRI) played a crucial part in clinching the diagnosis preoperatively. Laparotomy confirmed the preoperative findings and areas of saponification around the annulus was also seen. A lateral duodenojejunostomy was done and intraoperative core biopsy of the annular tissue was taken. Postoperative course was uneventful. Biopsy confirmed pancreatic tissue with fibrocollagenous tissue with no evidence of malignancy.This case is being presented for its rarity.
Journal of LIberia Medical and Dental Association, 2017
Background: Annular pancreas is one of the rarest causes of acute duodenal obstruction in neonates. The exact prevalence of annular pancreas is unclear as many individuals with annular pancreas are asymptomatic. We present a 7-day old male neonate who presented with non-bilious effortless coffee-ground vomitus from birth. He passed meconium with no subsequent motion of stool for 6days. Her radiograph showed a double bubble sign. He was diagnosed with a neonatal duodenal obstruction. Objective: To highlight the challenges in the diagnosis of neonatal duodenal obstruction. Materials and methods: The study is a case report of Annular Pancreas causing duodenal obstruction. The chart was retrieved and reviewed for the patient’s age, sex, clinical presentation, diagnosis and treatment. A search was conducted on the MEDLINE database for all applicable research; clinical reviews, retrospective studies and case reports. Results: The patient underwent duodeno-duodenostomy for an annular pancreas and the postoperative course was uneventful. Conclusion: Annular Pancreas is a rare disease in neonates causing duodenal obstruction. Imaging is supportive, but the diagnosis is confirmed by laparotomy. Duodeno-duodenostomy remains a viable operative option in neonates, Recommendation: A high index of suspicion is required by clinicians for diagnosis to avoid complications of delayed surgery.
International Journal of Surgery Case Reports, 2016
Annular pancreas (AP) in adults is a rare embryologic abnormality detected after development of complications or as incidental finding. Diagnosis and treatment strategies for symptomatic adult AP remain controversial. We describe two different presentation of AP: a woman with a specific upper abdominal pain treated with medical therapy and a man with upper gastroenteric obstructive symptoms which underwent surgical duodeno-jejunal bypass. English language literature about annular pancreas etiology, diagnosis and treatment was reviewed. No specific guidelines and protocols exist about management of AP, therefore, treatment and operative approaches must be individualized. In consideration of the possible post-operative complications, surgical treatment should be reserved in case of failure of conservative medical therapies.
SAS journal of medicine, 2022
Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue around the duodenum. Usually diagnosed in the neonatal period, the annular pancreas can be responsible for intestinal obstruction in 1% of cases. In adults it is asymptomatic in 50% of cases, as it can be responsible for duodenal stenosis, pancreatitis, or duodenal or gastric ulcerations. We report two cases of duodenal stenosis secondary to an annular pancreas diagnosed in two adults in whom a surgical bypass was performed allowing resolution of symptoms.
Annular pancreas: a cause of gastric outlet obstruction in a 20-year-old patient
The American journal of case reports, 2014
Annular pancreas is a congenital anomaly that consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It is formed due to the failure of the ventral bud to rotate, thus it elongates and encircles the upper part of the duodenum. It can present in a wide range of clinical severities, and can affect neonates to the elderly, making it difficult to diagnosis. Although diagnosis of annular pancreas can be made pre-operatively by upper GI series, upper GI endoscopy, or CT scan, 40% of diagnoses require surgery for confirmation. We report the case of a 20-year-old woman presenting with history of vomiting and weight loss since childhood. We present the clinical characteristics, surgical management in the form of bypass procedure done through a duodenojujenostomy, and follow-up of the patient. Annular pancreas occasionally presents in adults. Variable presentations have been described in the literature, including pancreatic neoplasm,...
Annular pancreas in adults: a report of two cases and review of literature
JOP : Journal of the pancreas, 2013
Annular pancreas is one of the rare congenital anomalies that can manifest itself in adulthood also. No specific guidelines and protocols exist about management of such cases. We hereby discuss our experience with two such cases along with a brief review of literature about the subject. The first patient was a male aged 27 years and presented with features of duodenal obstruction. He underwent duodenoduodenostomy . The second patient, a male aged 32 years, also presented with features of gastric outlet obstruction. He underwent Billroth type 2 reconstruction. Both patients had an uneventful recovery. Annular pancreas in adults is a rare clinical scenario. Advancements in imaging modalities have brought to forefront an even larger number of such cases. In adults it is diagnosed mainly because of the complications that arise thereof. Gastroduodenal tuberculosis can be an important differential diagnosis in endemic areas. Treatment and operative protocols have to be individualized.
A case with annular pancreas and accompanying ectopic pancreas
Laparoscopic Endoscopic Surgical Science
Congenital anomalies of the pancreas are quite common. The cases may present with different symptoms at different ages. While severe forms cause more noisy pictures in infancy and early childhood, mild forms may give symptoms in adulthood or they may be completely asymptomatic. Being aware of these anomalies guides clinicians in terms of diagnosis in clinical approach and helps prevent undesirable complications, especially during biliary, liver, and pancreatic operations. This case report aimed to present a case with annular pancreas and accompanying ectopic pancreas presenting in adult age with complaints consistent with severe upper gastrointestinal system obstruction with clinical, radiological, and endoscopic findings.
Annular Pancreas with Duodenal Stenosis and Intestinal
2013
Objective – To describe a rare case of a combination of annular pan-creas with malrotation in early childhood. Case report – The patient is 2 year old aged girl with persistent non-bilious vomiting. She was vomiting several times a week, and over the ten days prior to presen-tation as many as several times a day. Upon presentation, the patient had an unremarkable abdominal exam with no abdominal pain. An upper gastrointestinal study showed extreme dilatation of the stom-ach and the duodenal bulb, and an abdominal computer tomography scan revealed an annular pancreas. Intra-operatively we find an an-nular pancreas and treated it by duodeno-duodenostomy, while the intestinal malrotation was treated by Ladd’s procedure. Conclusion – Annular pancreas is a rare congenital anomaly which in childhood is related to duodenal atresia or stenosis and often affiliated with in-testinal malrotation. Key words: Annular pancreas ■ Malrotation.