Annular pancreas

• 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
  • Other congenital gastrointestinal problems
  • Pancreatitis
  • Excessive amniotic fluid during pregnancy (polyhydramnios)
• 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
• Signs 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.

• Expectations (prognosis)

  The outcome is usually good with surgery.

• Complications
  • Obstructive jaundice
  • 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 have any symptoms of annular pancreas.

• References

  Russo MA, Redel CA. 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. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 45.

Review Date: 1/21/2010

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.