Annular pancreas: Difference between revisions
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'''Annular pancreas''' is a rare condition in which the second part of the [[duodenum]] is surrounded by a ring of [[pancreas|pancreatic]] tissue continuous with the [[head of the pancreas]]. This portion of the pancreas can constrict the duodenum and block or impair the flow of food to the rest of the [[intestine]]s. It occurs in 1 out of 12,000 to 15,000 newborns.<ref name="pmid16254852">{{cite journal |author=Lainakis N, Antypas S, Panagidis A, ''et al'' |title=Annular pancreas in two consecutive siblings: an extremely rare case |journal=European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie |volume=15 |issue=5 |pages=364–8 |year=2005 |pmid=16254852 |doi=10.1055/s-2005-865838}}</ref> <ref>Yu, Jinxing, Turner, Mary Ann, Fulcher, Ann S., Halvorsen, Robert A. [http://www.ajronline.org/cgi/content/abstract/187/6/1544 Congenital Anomalies and Normal Variants of the Pancreaticobiliary Tract and the Pancreas in Adults: Part 2, Pancreatic Duct and Pancreas.] Am. J. Roentgenol. 2006 187: 1544-1553</ref> | '''Annular pancreas''' is a rare condition in which the second part of the [[duodenum]] is surrounded by a ring of [[pancreas|pancreatic]] tissue continuous with the [[head of the pancreas]]. This portion of the pancreas can constrict the duodenum and block or impair the flow of food to the rest of the [[intestine]]s. It occurs in 1 out of 12,000 to 15,000 newborns.<ref name="pmid16254852">{{cite journal |author=Lainakis N, Antypas S, Panagidis A, ''et al'' |title=Annular pancreas in two consecutive siblings: an extremely rare case |journal=European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie |volume=15 |issue=5 |pages=364–8 |year=2005 |pmid=16254852 |doi=10.1055/s-2005-865838}}</ref> <ref>Yu, Jinxing, Turner, Mary Ann, Fulcher, Ann S., Halvorsen, Robert A. [http://www.ajronline.org/cgi/content/abstract/187/6/1544 Congenital Anomalies and Normal Variants of the Pancreaticobiliary Tract and the Pancreas in Adults: Part 2, Pancreatic Duct and Pancreas.] Am. J. Roentgenol. 2006 187: 1544-1553</ref> | ||
==Causes== | ==Causes== | ||
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==Presentation== | ==Presentation== | ||
Early signs of abnormality include [[polyhydramnios]], or an excess of [[amniotic fluid]], [[low birth weight]], and feeding intolerance immediately after birth. | |||
* The anomaly may be discovered incidentally in asymptomatic patients. | |||
* In others, annular pancreas is associated with duodenal stenosis, postbulbar ulcerations, [[pancreatitis]], or biliary obstruction. | |||
* Surgical resection is recommended for symptomatic cases. | |||
* Early signs of abnormality include [[polyhydramnios]], or an excess of [[amniotic fluid]], [[low birth weight]], and feeding intolerance immediately after birth. | |||
==Diagnosis== | ==Diagnosis== | ||
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==Diagnostic Findings== | ==Diagnostic Findings== | ||
*ERCP: An aberrant pancreatic duct communicating with the main pancreatic duct and encircling the duodenum. | * ERCP: An aberrant pancreatic duct communicating with the main pancreatic duct and encircling the duodenum. | ||
*CT or MR images may show normal pancreatic tissue, with or without a small pancreatic duct, encircling the duodenum. | * CT or MR images may show normal pancreatic tissue, with or without a small pancreatic duct, encircling the duodenum. | ||
*Upper GI serier: Narrowing of the second portion of the duodenum. | * Upper GI serier: Narrowing of the second portion of the duodenum. | ||
==Treatment== | ==Treatment== | ||
Treatment usually is bypassing the obstructed segment of dudenum by duodeno-doudenostomy. Another approach is [[laparoscopic]] gastrojejunostomy.<ref name="pmid16494188">{{cite journal |author=De Ugarte DA, Dutson EP, Hiyama DT |title=Annular pancreas in the adult: management with laparoscopic gastrojejunostomy |journal=The American surgeon |volume=72 |issue=1 |pages=71–3 |year=2006 |pmid=16494188 |doi=}}</ref> | Treatment usually is bypassing the obstructed segment of dudenum by duodeno-doudenostomy. Another approach is [[laparoscopic]] gastrojejunostomy.<ref name="pmid16494188">{{cite journal |author=De Ugarte DA, Dutson EP, Hiyama DT |title=Annular pancreas in the adult: management with laparoscopic gastrojejunostomy |journal=The American surgeon |volume=72 |issue=1 |pages=71–3 |year=2006 |pmid=16494188 |doi=}}</ref> | ||
Revision as of 19:12, 15 March 2009
Annular pancreas | |
ICD-10 | Q45.1 |
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ICD-9 | 751.7 |
OMIM | 167750 |
MedlinePlus | 001142 |
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Overview
Annular pancreas is a rare condition in which the second part of the duodenum is surrounded by a ring of pancreatic tissue continuous with the head of the pancreas. This portion of the pancreas can constrict the duodenum and block or impair the flow of food to the rest of the intestines. It occurs in 1 out of 12,000 to 15,000 newborns.[1] [2]
Causes
It is typically associated with abnormal embryological development, however adult cases can develop.
Presentation
- The anomaly may be discovered incidentally in asymptomatic patients.
- In others, annular pancreas is associated with duodenal stenosis, postbulbar ulcerations, pancreatitis, or biliary obstruction.
- Surgical resection is recommended for symptomatic cases.
- Early signs of abnormality include polyhydramnios, or an excess of amniotic fluid, low birth weight, and feeding intolerance immediately after birth.
Diagnosis
Postnatal diagnostic procedures include abdominal x-ray and ultrasound, CT scan, and upper GI and small bowel series.
Diagnostic Findings
- ERCP: An aberrant pancreatic duct communicating with the main pancreatic duct and encircling the duodenum.
- CT or MR images may show normal pancreatic tissue, with or without a small pancreatic duct, encircling the duodenum.
- Upper GI serier: Narrowing of the second portion of the duodenum.
Treatment
Treatment usually is bypassing the obstructed segment of dudenum by duodeno-doudenostomy. Another approach is laparoscopic gastrojejunostomy.[3]
References
- ↑ Lainakis N, Antypas S, Panagidis A; et al. (2005). "Annular pancreas in two consecutive siblings: an extremely rare case". European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie. 15 (5): 364–8. doi:10.1055/s-2005-865838. PMID 16254852.
- ↑ Yu, Jinxing, Turner, Mary Ann, Fulcher, Ann S., Halvorsen, Robert A. Congenital Anomalies and Normal Variants of the Pancreaticobiliary Tract and the Pancreas in Adults: Part 2, Pancreatic Duct and Pancreas. Am. J. Roentgenol. 2006 187: 1544-1553
- ↑ De Ugarte DA, Dutson EP, Hiyama DT (2006). "Annular pancreas in the adult: management with laparoscopic gastrojejunostomy". The American surgeon. 72 (1): 71–3. PMID 16494188.
External Links
Template:SIB Template:Congenital malformations and deformations of digestive system