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Annular pancreas

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.

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:

Exams and Tests

Tests include:

Treatment

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

Outlook (Prognosis)

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

Possible Complications

Complications may include:

When to Contact a Medical Professional

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

References

Bales C, Liacouras CA. Intestinal atresia, stenosis, and malrotation. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 330.

Semrin MG, Russo MA. Anatomy, histology, embryology, and developmental anomalies of the stomach and duodenum. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 48.

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Endocrine glands

      Endocrine glands - illustration

      Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

      Endocrine glands

      illustration

    • Annular pancreas

      Annular pancreas - illustration

      Annular pancreas is an abnormal ring or collar of pancreatic tissue that encircles the duodenum (the part of the small intestine that connects to stomach). This portion of pancreas can constrict the duodenum and block or impair the flow of food to the rest of the intestines. Symptoms from annular pancreas are nausea, vomiting, feeling of fullness after eating, and feeding problems in newborns. Surgical bypass of the obstructing segment of the duodenum is the usual treatment for this disorder.

      Annular pancreas

      illustration

      • Digestive system

        Digestive system - illustration

        The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

        Digestive system

        illustration

      • Endocrine glands

        Endocrine glands - illustration

        Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

        Endocrine glands

        illustration

      • Annular pancreas

        Annular pancreas - illustration

        Annular pancreas is an abnormal ring or collar of pancreatic tissue that encircles the duodenum (the part of the small intestine that connects to stomach). This portion of pancreas can constrict the duodenum and block or impair the flow of food to the rest of the intestines. Symptoms from annular pancreas are nausea, vomiting, feeling of fullness after eating, and feeding problems in newborns. Surgical bypass of the obstructing segment of the duodenum is the usual treatment for this disorder.

        Annular pancreas

        illustration

      Review Date: 10/27/2015

      Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. 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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