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What is an Annular Pancreas?

By D. Jeffress
Updated Mar 03, 2024
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An annular pancreas is a congenital deformity in which part of the organ becomes wrapped around a section of the duodenum, the upper neck of the small intestine. If the pancreas completely obstructs the duodenum, the condition is noticeable shortly after birth as an infant is unable to feed. In most cases, however, the intestine is only partially obstructed, if at all, and an annular pancreas is not detected until some time in adulthood. The condition is usually treated with surgery to bypass the duodenum and connect the stomach to a lower section of the small intestine.

The pancreas is normally positioned adjacent to the duodenum, just underneath the stomach. Problems occur if the head of the pancreas forms a ring around the duodenum instead of resting against it. Infants who are born prematurely are at the highest risk of having the deformity, as the head and neck of the pancreas may never fully develop. It is common for a baby to have other defects as well, such as an underdeveloped esophagus or Down syndrome. An infant who has an annular pancreas may not be able to digest milk, causing him or her to spit up regularly.

If an annular pancreas does not completely encircle the duodenum, it may not cause noticeable symptoms in infancy. In fact, an annular pancreas often goes undiagnosed until it is discovered during a medical examination for another condition. If symptoms do arise in adulthood, they may include nausea, vomiting, food intolerance, and a constant feeling of fullness. Pancreatitis, inflammation and swelling of the pancreas, often triggers such symptoms in adults.

A doctor can diagnose an annular pancreas in an infant or an adult by performing a series of diagnostic imaging tests. Ultrasounds, x-rays, and computerized tomography scans are used to detect abnormalities and gauge the severity of duodenal obstruction. After making a diagnosis, the doctor can refer the patient to an internal medicine specialist to evaluate the need for surgery.

The most common surgical procedure to treat an annular pancreas is called a duodenoduodenostomy. During the procedure, a surgeon inserts a tiny camera into the abdominal cavity to inspect the stomach and small intestine. He or she makes a series of small incisions in the lower abdomen and manipulates surgical tools to sever the stomach from the duodenum, bypass the section constrained by the pancreas, and connect it to the next section of the intestine. The surgery has a high success rate, and most infants and adults recover completely in a few months.

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Discussion Comments
By Lugusta777 — On Apr 27, 2015

I am a 54 year old male. About four months ago I was diagnosed with a annular pancreas, which to me, explains a lot. I've also had diabetes since I was 22 years old, and I am beginning to wonder if the two are related. They're still doing tests, however I have a lot of pain at times in my right side. My doc says my duodenum is about 40-60 percent blocked, but food is still getting through.

I'd like to know for those of you who had the surgery, what was the recovery time and how long were you out of work? Have any of you that had the surgery had it done in the San Francisco Bay area? If I have if done I want someone who is experience doing this type of surgery, so any of you who may live in the SF Bay Area can recommend a good surgeon I'd really appreciate it.

By Oceana — On Jan 27, 2012

My six-year-old started having attacks of pancreatitis. We had no idea that anything was wrong with him until he started having severe pain in his upper abdomen.

The pain made him bend over and cry loudly. I took him to the emergency room, where he received x-rays.

They found that his pancreas was inflamed, but they also found that he had an annular pancreas. He had to be treated for the pancreatitis before they could do surgery to fix the underlying cause.

He stayed in the hospital, where he ate a liquid diet with a few bland foods thrown in and received intravenous fluids to keep him hydrated. Once his pancreas had recovered, he had the surgery to fix the problems caused by his annular pancreas.

By kylee07drg — On Jan 27, 2012

@StarJo – I wish that loss of appetite had been my only sign that I had an annular pancreas. My symptoms were much more unpleasant.

I was twenty-six when I started becoming severely nauseated. I vomited after lunch one day, and for the next two days, I could not keep any food down.

My doctor originally thought it must be a stomach virus. After a week had passed and I still could not hold any food in my system, she did a more in-depth examination and found my annular pancreas.

I also had the surgery, and now I'm fine. For that week prior to the surgery, I really thought I might be dying, though.

By StarJo — On Jan 26, 2012

I didn't know I had an annular pancreas until I was thirty-seven years old. It had given me no problems for the first 36 years of my life, so I thought I was perfectly healthy.

A few weeks after my thirty-seventh birthday, I stopped having an appetite. I would wake up in the morning and start to put some toast in the toaster, but before I got to it, I would realize that I had no desire to eat.

By dinnertime, I still had no hunger, so I knew something must be wrong. I scheduled an appointment with my doctor, who did some scans and found the annular pancreas.

I had to have pancreas surgery, and after I recovered, my appetite returned fully. I have even put on weight since then.

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