Duodenal obstruction due to anular pancreas

Abstract

Annular pancreas (AP) is a rare congenital anomaly, characterized by ectopic pancreatic tissue surrounding the duodenum, that may associate with duodenal obstruction.
We present a patient complaining of 12 days of abdominal pain and vomits. Blood tests showed hyperlipasemia. Computed tomography scan demonstrated stomach and first duodenal portion distended in relation to a 5 cm diameter image resembling a ring between the pancreatic head and the second portion of the duodenum, a well known characteristic of AP. Following a lack of clinical response to medical treatment, surgery was performed confirming a duodenal obstruction due to AP. Roux-en-Y gastrojejunostomy was done, with good postoperative outcome.
Annular pancreas may present as a duodenal obstruction. For these cases, we suggest surgical treatment to confirm diagnosis and resolve the obstruction in cases with negative clinical response to conservative treatment