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Annular pancreas
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Annular pancreas

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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.

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 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

I Would Like to Learn About:

  • 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 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 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
  • Exams and Tests

    Tests include:

    • Abdominal ultrasound
    • Abdominal x-ray
    • CT scan
    • Upper GI and small bowel series
  • Treatment

    Treatment most often involves surgery to bypass the blocked part of the duodenum.

  • Outlook (Prognosis)

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

  • Possible Complications

    • Obstructive jaundice
    • Pancreatic cancer
    • Pancreatitis (inflammation of the pancreas)
    • Peptic ulcer
    • Perforation (tearing a hole) of the intestine due to obstruction
    • Peritonitis
  • When to Contact a Medical Professional

    Call your health care provider if you or your child has any symptoms of annular pancreas.

Related Information

  DuodenumIncidencePeptic ulcerPeritonitis     Peptic ulcers

References

Semrin MG, Russo MA. 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. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 45.

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Review Date: 2/11/2014  

Reviewed By: Todd Eisner, MD, Private practice specializing in Gastroenterology, Boca Raton, FL. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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