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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
  • 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:

Signs and tests

Tests include:

Treatment

Surgical bypass of the blocked part of the duodenum is the usual treatment for this disorder.

Support Groups

Expectations (prognosis)

The outcome is usually good with surgery. Adults with an annular pancreas are at increased risk for pancreatic or biliary tract cancer.

Complications

  • Obstructive jaundice
  • Pancreatic cancer
  • 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 has any symptoms of annular pancreas.

Prevention

References

Semrin MG, Russo MA. Anatomy, histology, embryology, and developmental anomalies of the stomach and duodenum. In: Feldman M, Friedman LS, Brandt LJ, eds. . 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 45.

Encyclopedia content is provided as information only and not intended to replace the advice and instruction from your personal physician.