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Asian Journal of Surgery Jan 2022
Topics: Foot; Hand; Humans; Pancreas; Pancreatic Diseases
PubMed: 34823993
DOI: 10.1016/j.asjsur.2021.11.035 -
Cureus Mar 2018Portal annular pancreas is a rare congenital anomaly in which the portal vein and/or the splenoportal confluence are completely encircled by aberrant pancreatic...
Portal annular pancreas is a rare congenital anomaly in which the portal vein and/or the splenoportal confluence are completely encircled by aberrant pancreatic parenchyma. It is an asymptomatic condition and is usually an incidental finding. It is, however, important to a surgeon because the postoperative pancreatic fistula (POPF) rates following pancreatic resection are higher in patients with this anomaly. A 47-year-old male presented with features of obstructive jaundice. He was diagnosed to have periampullary carcinoma, and pancreatoduodenectomy was planned. During surgery, uncinate process was seen extending posterior to the portal vein and was communicating with the body of pancreas to the left of the portal vein. After transection, there were two pancreatic stumps. The pancreatic duct was identified in the stump anterior to the portal vein. No duct was present in the posterior pancreatic stump. We closed the posterior pancreatic stump with interrupted polypropylene sutures and performed a duct to mucosa pancreaticojejunostomy in the anterior stump. On reviewing the preoperative computed tomography (CT) scan, we were able to identify the pancreatic tissue encasing the portal vein superior to the splenic vein. Circumportal pancreas is classified based on the orientation of pancreatic duct to the portal vein and the relationship of the aberrant pancreatic tissue with the splenoportal confluence. Following pancreatoduodenectomy, the surgeon has to manage two pancreatic stumps, one anterior and the other posterior to the portal vein. No standardised technique has been described for management of the pancreatic stumps. Every surgeon planning pancreatic surgery should be aware of this rare anomaly, and look for the same in the preoperative CT scan so that appropriate plan can be made regarding the type of pancreatic anastomosis.
PubMed: 29805935
DOI: 10.7759/cureus.2366 -
Singapore Medical Journal Jan 2009Annular pancreas is an uncommon congenital anomaly that usually presents early in childhood. The role of endoscopic ultrasonography in the diagnosis of this condition...
Annular pancreas is an uncommon congenital anomaly that usually presents early in childhood. The role of endoscopic ultrasonography in the diagnosis of this condition has been only sparsely reported. We present annular pancreas in a 50-year-old man; the anomaly was initially suspected during endoscopy and endoscopic ultrasonography, and subsequently confirmed on magnetic resonance cholangiopancreatography.
Topics: Cholangiopancreatography, Magnetic Resonance; Endosonography; Humans; Male; Middle Aged; Pancreas
PubMed: 19224066
DOI: No ID Found -
Journal of Indian Association of... 2015Colonic atresia is the rarest entity among the all intestinal atresias and may be associated with anterior abdominal wall defect, small intestinal atresia,...
Colonic atresia is the rarest entity among the all intestinal atresias and may be associated with anterior abdominal wall defect, small intestinal atresia, Hirschsprung's disease, and other anomalies. Here, we are reporting a case of colonic atresia associated with annular pancreas, which has not been reported previously to the best of our knowledge.
PubMed: 26166992
DOI: 10.4103/0971-9261.159036 -
International Journal of Clinical and... 2015Annular pancreas is a rare congenital anomaly characterized by pancreatic tissues wrapping completely or incompletely around the descending duodenum. In most patients...
OBJECTIVES
Annular pancreas is a rare congenital anomaly characterized by pancreatic tissues wrapping completely or incompletely around the descending duodenum. In most patients with annular pancreas, onset occurs in early childhood. Adults with annular pancreas are prone to duodenal ulcers and pancreatitis. Intraductal papillary mucinous neoplasm (IPMN) is a type of papillary mucinous secretory epithelial tumor, which originates in the main pancreatic duct and/or branch duct. We report a case of annular pancreas accompanied with intraductal papillary mucinous neoplasm.
METHODS
A 52-year-old male patient hospitalized due to recurrent upper abdominal pain for one and a half years was enrolled in this study.
RESULTS
One case of annular pancreas accompanied with intraductal papillary mucinous neoplasm which manifested as recurrent chronic pancreatitis was found. After pancreaticoduodenectomy, the patient died from uncontrollable gastrointestinal bleeding.
CONCLUSIONS
To the best of our knowledge, this is the first case in China and the second case worldwide of annular pancreas accompanied with IPMN in English literature.
PubMed: 26064223
DOI: No ID Found -
DEN Open Apr 2022Annular pancreas is a congenital abnormality in which part of the pancreatic head completely or partially surrounds the duodenum in a ring-like manner. The condition is...
Annular pancreas is a congenital abnormality in which part of the pancreatic head completely or partially surrounds the duodenum in a ring-like manner. The condition is thought to be an abnormality of the ventral pancreatic bud. While pancreatitis is a common complication of the annular pancreas, its recurrence may be prevented by improving the outflow of pancreatic juice. The present case report describes a 23-year-old woman who had been referred to our hospital for recurrent pancreatitis since childhood. An endoscopic incision was made on the orifice of the annular pancreas, after which pancreatitis of the annular pancreas did not recur for 6 years. The patient subsequently exhibited pancreatolithiasis in the dorsal pancreatic duct, which was successfully treated with endoscopic treatment. Endoscopic pancreatic sphincterotomy may prevent the recurrence of pancreatitis and avoid further surgical interventions by improving the flow of pancreatic juice.
PubMed: 35873513
DOI: 10.1002/deo2.122 -
The Korean Journal of Gastroenterology... Jul 2012Portal annular pancreas is one of the pancreatic fusion anomalies in which the uncinate process of the pancreas extends to fuse with the dorsal pancreas by encircling...
Portal annular pancreas is one of the pancreatic fusion anomalies in which the uncinate process of the pancreas extends to fuse with the dorsal pancreas by encircling the portal vein or superior mesenteric vein. We report two consecutive patients with portal annular pancreas. The first case is a 71-year-old male patient who underwent a pancreaticoduodenectomy for intraductal papillary mucinous neoplasm in the head of pancreas. His preoperative computed tomography scan showed the suprasplenic type portal annular pancreas. The second case is a 74-year-old female patient who underwent a laparoscopic anterior radical antegrade modular pancreatosplenectomy (RAMPS) for pancreatic body cancer. In operative finding, portal confluence (superior mesenteric vein-splenic vein-portal vein) was encased with the uncinate process of pancreas in both cases. Therefore, they required pancreatic division at the pancreatic neck portion twice. During the postoperative period, grade B and A, respectively, postoperative pancreatic fistulas occurred and were controlled by conservative management. Surgeons need to know about this rare pancreatic condition prior to surgical intervention to avoid complications, and to provide patients with well-designed, case-specific pancreatic surgery.
Topics: Adenocarcinoma, Mucinous; Aged; Female; Humans; Male; Mesenteric Veins; Pancreas; Pancreatic Diseases; Pancreatic Fistula; Pancreatic Neoplasms; Pancreaticoduodenectomy; Portal Vein; Splenic Vein; Tomography, X-Ray Computed
PubMed: 22832801
DOI: 10.4166/kjg.2012.60.1.52 -
BMJ Case Reports Jun 2019Annular pancreas (AP) is a rare diagnosis in the adult population but can cause significant morbidity if not correctly identified. In adults, the most common symptoms...
Annular pancreas (AP) is a rare diagnosis in the adult population but can cause significant morbidity if not correctly identified. In adults, the most common symptoms are abdominal pain, nausea and vomiting. While these are not specific to AP, they are important clues to this diagnosis in the right clinical context. We present the case of a 24-year-old woman presenting with a 6-year history of progressive abdominal pain and dyspepsia in the context of an extensive negative workup. Upper gastrointestinal (GI) series and MRI revealed partial duodenal obstruction, concerning for AP. While patients with chronic abdominal pain and vague GI complaints may be diagnosed with functional bowel disorders, it is important to appropriately address the possibility of an underlying structural lesion such as AP. This strategy is not only cost-effective but also saves the patient discomfort associated with unnecessary procedures and allows a timely intervention.
Topics: Abdominal Pain; Duodenal Obstruction; Female; Humans; Laparoscopy; Pancreas; Pancreatic Diseases; Treatment Outcome; Upper Gastrointestinal Tract; Young Adult
PubMed: 31227569
DOI: 10.1136/bcr-2019-229223 -
Radiology Case Reports Apr 2021Annular pancreas is a rare congenital intestinal obstruction to be found in infants. It is characterized by nonbilious vomiting, abdominal distention, and feeding...
Annular pancreas is a rare congenital intestinal obstruction to be found in infants. It is characterized by nonbilious vomiting, abdominal distention, and feeding intolerance that share similar symptoms with other intestinal obstructions. We reported a case of 11-month-old female infant with a history of nonbilious vomiting after coughing as much as 6 times per day 1 day before admission. The patient had an incorrect provisional diagnosis of hypertrophic pyloric stenosis based on ultrasound. Later on, an upper gastrointestinal series showed dilatation of the second part of the duodenum which was successfully treated by a duodenostomy during laparotomy procedure. It is suggested that treating an intestinal obstruction needs a further investigation when the symptoms were continuously repeated.
PubMed: 33537107
DOI: 10.1016/j.radcr.2021.01.019 -
VideoGIE : An Official Video Journal of... Jan 2020
PubMed: 31922076
DOI: 10.1016/j.vgie.2019.09.004