Incidence estimated at around 1/50,000 births, representing 10 % of duodenal stenosis cases. Rotational abnormality of the ventral pancreatic bud at the 5th week of development, resulting in the formation of a ring of pancreatic parenchyma surrounding the 2nd duodenum, more or less incorporated into its wall. This pancreatic ring leads to duodenal stenosis. Neonatal presentation in the form of neonatal occlusion is the most common, but later presentations in the form of acute or chronic obstructive pancreatitis have been described.
During the neonatal period :
- epigastric distension
- vomiting, which is not bilious because the obstruction is generally supra-vaterial (above the junction of the bile ducts).
- malformations of the cranial segment of the bowel are frequently associated, as is the case with other duodenal atresias.
- heart disease may also be present.
- chromosomal abnormalities are present in 30 % of cases, the most frequent being trisomy 21 (followed by 18 and 13).
Anesthetic implications:
neonatal surgery; management of duodenal atresia; see associated anomalies
References :
- Wani AA, Maqsood S, Lala P, Wani S.
Annular pancreas in adults: a report of two cases and review of literature.
JOP 2013 ;14 :277-279.
- Türkvatan A, Erden A, Türkoğlu MA, Yener Ö.
Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography.
Korean J Radiol 2013;14 :905-1001
Updated: December 2023