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    Annular pancreas

    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

    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
    • Excess amniotic fluid during pregnancy (polyhydramnios)
    • Other congenital gastrointestinal problems
    • Pancreatitis

    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

    Exams and Tests

    Tests include:

    • Abdominal ultrasound
    • Abdominal x-ray
    • CT scan
    • Upper GI and small bowel series

    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. Adults with an annular pancreas are at increased risk for pancreatic or biliary tract cancer.

    Possible Complications

    • Obstructive jaundice
    • Pancreatic cancer
    • Pancreatitis (inflammation of the pancreas)
    • Peptic ulcer
    • Perforation (tearing a hole) 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 has any symptoms of annular pancreas.

    References

    Semrin MG, Russo MA. 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. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 45.

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    • Digestive system

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    • Endocrine glands

      illustration

    • Annular pancreas

      illustration

      • Digestive system

        illustration

      • Endocrine glands

        illustration

      • Annular pancreas

        illustration

      A Closer Look

        Self Care

          Tests for Annular pancreas

            Review Date: 2/19/2012

            Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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            St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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