Annular Pancreas

What is annular pancreas?

The pancreas is an accessory organ of the digestive system. It lies posterior to the abdomen, right behind the stomach. The pancreas is linked to the small intestine through a small duct. Specifically, the pancreas connects to the duodenum. The pancreas secretes a hormone known as insulin into the bloodstream. This insulin promotes the uptake of glucose by the cells, transforming it to energy for smooth metabolism. The pancreas also secretes enzymes into the intestines to enhance food digestion. The pancreas lies in close proximity to your duodenum. In some persons, the pancreatic tissue may surround the duodenum. In such cases, the pancreas becomes blocked or restricted. This condition is referred to as, annular pancreas.

Annular pancreas
Photo Credit: MedlinePlus

What causes annular pancreas?

Annular pancreas is congenital. This means that the individual is born with it. Even though the primary cause of the disorder is not yet known, we know that it occurs alongside other congenital ailments such as:

  • 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 alongside polyhydramnios. This is not a common condition. Research has shown that only one in every 20,000 newborns have it. It is more common in males than in females.

Symptoms of annular pancreas

Symptoms occur when the pancreatic tissue surrounds the small intestine and squeezes it. In some patients, the tissue surrounding the duodenum may be so small that no symptom occurs.  This happens in over 50% of cases.

In other cases, a blockage may occur, so severe that the person finds it difficult to eat. Infants who have this condition spit excessively, and cry, and may not be able to suck breast milk or drink enough formula.

At times, this condition fails to develop until adulthood. When the symptoms finally show up, what is experienced include:

  • a sensation of fullness after eating just a little quantity of food
  • nausea or vomiting

Diagnosing annular pancreas

If you have symptoms of annular pancreas, your physician will, first of all, ask about your medical history, whether or not you have had congenital issues in the past. A number of tests may be done to confirm the diagnosis. Tests used for confirmation of annular pancreas include:

Treatment for annular pancreas

You may be asked to undergo surgery to bypass the pancreatic tissue. Why this is done is to help clear the obstruction so that your small intestine can operate at physiological levels. If the pancreatic tissue is destroyed, it may permanently damage the pancreas.

Duodenojejunostomy and gastrojejunostomy are the widely used surgical options for an annular pancreas. Your intestine will be cut at the site of the blockage, and then reconnected in an area that away from the site of obstruction.

Preventing annular pancreas

Surprisingly, an annular pancreas cannot be prevented. It is a congenital condition and occurs during the development of the fetus. However, you can have a healthy pregnancy and a healthy baby. Following the steps below will help you achieve this:

  • Eat healthily during pregnancy. Your diet should be rich in vegetables, whole grains and, fruits.
  • Attend regular prenatal checkups.
  • If you are a smoker, please stop. And if you are not a smoker, do not start at all.
  • Do not take drugs that have not been prescribed by your physician.
  • Avoid alcohol.

What is the prognosis for annular pancreas?

If you are diagnosed with an annular pancreas, then a surgery is inevitable. After surgery, you will recover quite speedily, with high chances of a good long-term outlook. If the condition occurs in adulthood, then you are at high risk of having complications. Complications associated with annular pancreas 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

Adults with an annular pancreas are also at high risk of cancer, including pancreatic and biliary tract cancer.

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