Images in Clinical Medicine
Annular Pancreas
N Engl J Med 1997; 336:1794June 19, 1997
- Article
Figure 1 A 79-year-old man had a five-month history of dull, aching epigastric pain radiating to the back and a 16-kg (35-lb) weight loss. The pain was made worse by meals and was associated with early satiety. An upper gastrointestinal series (Panel A) showed a duodenal diverticulum (D) and nonobstructing narrowing in the second part of the duodenum (arrow). Esophagogastroduodenoscopy revealed extrinsic compression of the second part of the duodenum, and computed tomography of the abdomen showed an enlarged pancreatic head with no focal mass. Because pancreatic cancer was suspected, endoscopic retrograde cholangiopancreatography was performed (Panel B), revealing a circumferential pancreatic duct in the head of the pancreas (arrows), encircling the second part of the duodenum. This finding is diagnostic of annular pancreas. The patient had a pylorus-preserving duodenoduodenostomy. Multiple biopsies of the pancreas were negative for cancer. Six months after surgery the patient remained asymptomatic and had gained 9 kg (20 lb).
Aslam Godil, M.D.
John D. McCracken, M.D.
Loma Linda University Medical Center, Loma Linda, CA 92354- Citing Articles (2)
Citing Articles
1
Jin-Young Choi, Myeong-Jin Kim, Joo Hee Kim, Joon Seok Lim, Young Taik Oh, Jae-Joon Chung, Si Young Song, Jae Bock Chung, Hyung Sik Yoo, Jong Tae Lee, Ki Whang Kim. (2004) Annular Pancreas. Journal of Computer Assisted Tomography 28:4, 528-532
CrossRef2
Bunsei Nobukawa, Masahiko Otaka, Koichi Suda, Hideki Fujii, Yoshiro Matsumoto, Takeshi Miyano. (2000) An Annular Pancreas Derived from Paired Ventral Pancreata, Supporting Baldwin's Hypothesis. Pancreas 20:4, 408-410
CrossRef
