- Email: [email protected]
Annular pancreas
HPB
DOI:10.1111/j.1477-2574.2010.00153.x
IMAGE OF THE MONTH
Annular pancreas J Jarry, T Wagner, M Shekher & A Sa Cunha Department of Surgery, Hopital Haut Leveque, Pessac, France
Correspondence Julien Jarry, Department of Surgery, Hopital Haut Leveque, Avenue de Magellan, 33000 Pessac, France, Tel: (+33) 0664352995, FAX: (+33) 0556847005, Email: [email protected]
During cholecystectomy for symptomatic gallstone disease in a 72-year-old lady, operative cholangiography demonstrated an opacified pancreatic duct surrounding the duodenum (figure 1). Abdominal CT revealed an annular pancreas (figure 2). This rare, congenital anomaly comprises a ring of pancreatic tissue that encircles the second part of the duodenum in 74% of patients.1 This embryologic migration fault affects approximately 1 in 20 000 newborns.1 Although rare, it may become symptomatic in adults and may be associated with peptic ulceration, pancreatitis, or duodenal obstruction. Gastrojejunostomy is the preferred method of treatment for persistent duodenal obstruction.2 Resection is recommended only when it is associated with pancreatolithiasis leading to chronic pancreatitis.
HPB 2010, 12, 225
Conflicts of interest None declared.
References 1. Paraskevas G, Papaziogas B, Lazaridis C et al. (2001) Annular pancreas in adults: embryological development, morphology and clinical significance. Surg Radiol Anat 23:437–442. 2. Chen YC, Yeh CN, Tseng JH. (2003) Symptomatic adult annular pancreas. J Clin Gastroenterol 36:446–450.
© 2010 International Hepato-Pancreato-Biliary Association
DOI:10.1111/j.1477-2574.2010.00153.x
IMAGE OF THE MONTH
Annular pancreas J Jarry, T Wagner, M Shekher & A Sa Cunha Department of Surgery, Hopital Haut Leveque, Pessac, France
Correspondence Julien Jarry, Department of Surgery, Hopital Haut Leveque, Avenue de Magellan, 33000 Pessac, France, Tel: (+33) 0664352995, FAX: (+33) 0556847005, Email: [email protected]
During cholecystectomy for symptomatic gallstone disease in a 72-year-old lady, operative cholangiography demonstrated an opacified pancreatic duct surrounding the duodenum (figure 1). Abdominal CT revealed an annular pancreas (figure 2). This rare, congenital anomaly comprises a ring of pancreatic tissue that encircles the second part of the duodenum in 74% of patients.1 This embryologic migration fault affects approximately 1 in 20 000 newborns.1 Although rare, it may become symptomatic in adults and may be associated with peptic ulceration, pancreatitis, or duodenal obstruction. Gastrojejunostomy is the preferred method of treatment for persistent duodenal obstruction.2 Resection is recommended only when it is associated with pancreatolithiasis leading to chronic pancreatitis.
HPB 2010, 12, 225
Conflicts of interest None declared.
References 1. Paraskevas G, Papaziogas B, Lazaridis C et al. (2001) Annular pancreas in adults: embryological development, morphology and clinical significance. Surg Radiol Anat 23:437–442. 2. Chen YC, Yeh CN, Tseng JH. (2003) Symptomatic adult annular pancreas. J Clin Gastroenterol 36:446–450.
© 2010 International Hepato-Pancreato-Biliary Association