Annular Pancreas: Causes, Symptoms and Diagnosis

Annular Pancreas

What Is Annular Pancreas?

The pancreas is an organ in the posterior (back) of your abdomen, just behind the stomach. A duct connects the pancreas to a part of the small intestine called the duodenum. It is responsible for excreting insulin into the bloodstream to transform glucose into energy. It also secretes enzymes into the intestines to directly aid in the digestion of food.

Normally, your pancreas sits next to your duodenum in your abdomen. In some people, tissue from the pancreas may surround the duodenum. When this happens, your duodenum can become restricted or blocked. This may impact your ability to digest food. This condition is known as annular pancreas.

What Are the Causes of Annular Pancreas?


Annular pancreas is a congenital condition. This means that it’s typically present at birth. Although doctors don’t know what causes the disorder, annular pancreas commonly occurs with other congenital disorders, including:

  • Down’s syndrome
  • tracheoesophageal fistula, an abnormal connection between the esophagus and the trachea
  • intestinal atresia, the failure of a portion of the intestinal tract to completely form
  • pancreas divisum, a birth defect in which ducts of the pancreas don’t join together

Annular pancreas also occurs with polyhydramnios, or excess amniotic fluid during pregnancy. Annular pancreas is a rare condition that occurs in only 1 in every 20,000 newborns. It occurs more frequently in males than females.

What Are the Symptoms of Annular Pancreas?


Symptoms of annular pancreas develop when tissue from the pancreas squeezes the small intestine. In some people, the tissue that surrounds the duodenum may be so small that it doesn’t cause any symptoms. This happens in half of all patients with this condition.

In other cases, the pancreatic tissue surrounding the small intestine causes a blockage that can make it difficult for a person to eat. Infants with annular pancreas may cry, spit up more than normal, and be unable to drink enough formula or breast milk.

Sometimes symptoms of annular pancreas don’t develop until adulthood. When symptoms occur, they may include:

  • fullness sensation after eating only a small amount
  • nausea or vomiting

How Is Annular Pancreas Diagnosed?


If you have symptoms of this disorder, your doctor will ask you about your health history, including underlying congenital problems that you have or had in the past. Your doctor may need to order several tests to confirm your diagnosis. Tests used to confirm a diagnosis of annular pancreas include:

  • ultrasound of the abdomen
  • X-ray of the abdomen
  • CT scan
  • MRI study of the abdomen
  • upper gastrointestinal (GI) series
  • small bowel series

How Is Annular Pancreas Treated?


Your doctor may recommend surgery to bypass the pancreatic tissue. The goal of treatment is to remove the obstruction so that your small intestine can function normally. Typically, you can’t remove pancreatic tissue from the duodenum. Destruction of the pancreatic tissue can cause damage to the pancreas.

Surgical options for annular pancreas include gastrojejunostomy or duodenojejunostomy. These procedures will require your doctor to cut the intestine at the site of the blockage and reconnect the two parts of the intestine in an area below the obstruction.

How Can I Prevent Annular Pancreas?


You can’t prevent annular pancreas. The condition occurs due to genetic changes during fetal development. However, there are steps you can take to have a healthy pregnancy and a healthy baby:

  • Maintain a healthy diet during pregnancy, including fruits, vegetables, and whole grains.
  • See your doctor regularly for prenatal checkups.
  • Stop smoking or don’t start smoking.
  • Don’t consume drugs that aren’t prescribed by your doctor.
  • Don’t consume alcohol.

What Is the Long-Term Outlook?


If you receive a diagnosis of annular pancreas, you’ll need surgery to correct the problem. Following surgery, your recovery and long-term outlook should be quite good. If you have annular pancreas as an adult, you’re at higher risk for complications from the disorder. Complications may include:

  • obstructive jaundice: obstruction in the flow of bile
  • pancreatitis: inflammation of the pancreas
  • peptic ulcer: a defect in the lining of the stomach or the first part of the intestine
  • perforation (hole) in the intestine
  • peritonitis: inflammation of the tissue that lines the inner wall of the abdomen

In addition, adults who have annular pancreas have a higher risk for developing certain types of cancer, including biliary tract and pancreatic cancer.

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