Annular pancreas
An annular pancreas is a ring of pancreatic tissue that encircles the duodenum (the first part of the small intestine). The normal position of the pancreas is next to, but not surrounding the duodenum.
Duodenum
The duodenum is the first part of the small intestine. It is located between the stomach and the middle part of the small intestine, or jejunum. Aft...
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Causes
Annular pancreas is problem present at birth (congenital defect). 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 one 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)
(polyhydramnios)
Polyhydramnios occurs when too much amniotic fluid builds up during pregnancy. It is also called amniotic fluid disorder, or hydramnios.
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- Pancreatitis
Symptoms
Newborns may not feed well. 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
Nausea or vomiting
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...
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Exams and Tests
Tests include:
- Abdominal ultrasound
Abdominal ultrasound
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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Abdominal x-ray
An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...
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- Upper GI and small bowel series
Upper GI and small bowel series
An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test th...
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Treatment
Treatment most often involves surgery to bypass the blocked part of the duodenum.
Outlook (Prognosis)
The outcome is most often good with surgery. Adults with an annular pancreas are at increased risk for pancreatic or biliary tract cancer.
Possible Complications
Complications may include:
- Obstructive jaundice
- Pancreatic cancer
Pancreatic cancer
Pancreatic cancer is cancer that starts in the pancreas.
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- Peptic ulcer
- Perforation (tearing a hole) of the intestine due to obstruction
- Peritonitis
Peritonitis
Peritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of t...
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When to Contact a Medical Professional
Contact your health care provider if you or your child has any symptoms of annular pancreas.
Review Date:
10/26/2021
Reviewed By
Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
References
Maqbool A, Bales C, Liacouras CA. Intestinal atresia, stenosis, and malrotation. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 356.
Mehta MS, Barth BA, Husain SZ. Anatomy, histology, embryology, and developmental anomalies of the pancreas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 55.
Semrin MG. Anatomy, histology, and developmental anomalies of the stomach and duodenum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 49.
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