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Case No. 23: Annular Pancreas

Case No. 23: Annular Pancreas

Annular Pancreas - CT Abdomen (Axial View) radiologydefinitiondotcom Final
Annular Pancreas – CT Abdomen (Axial View)

Modality:

CT Abdomen (Axial View)

Report: 

The CT examination revealed the presence of a band of pancreatic tissue encircling the descending duodenum. No other abnormality is seen.

Diagnosis:

Annular Pancreas

Key Points:

This congenital abnormality results from incomplete rotation of the ventral pancreas and a segment of the pancreas encircles the descending duodenum. There are two forms of the annular pancreas: The extra-mural form, where the ventral pancreatic duct encircles the duodenum to join the main pancreatic duct. In the intramural form, the pancreatic tissue penetrates in the muscular layer of the duodenum and the small ducts drain directly into the duodenum.

In about half of the symptomatic patients, it will present with gastrointestinal or biliary duct obstruction in neonates, whereas in adults it will manifest with dyspepsia, duodenal obstruction (in about 10% of cases) or pancreatitis.

On CT and MR, a band of pancreatic tissue is seen encircling the second portion of the duodenum. MR is advantageous because it allows depiction of the main pancreatic duct.[:de]

Case No. 23: Annular Pancreas

Annular Pancreas - CT Abdomen (Axial View) radiologydefinitiondotcom Final
Annular Pancreas – CT Abdomen (Axial View)

Modality:

CT Abdomen (Axial View)

Report: 

The CT examination revealed the presence of a band of pancreatic tissue encircling the descending duodenum. No other abnormality is seen.

Diagnosis:

Annular Pancreas

Key Points:

This congenital abnormality results from incomplete rotation of the ventral pancreas and a segment of the pancreas encircles the descending duodenum. There are two forms of the annular pancreas: The extra-mural form, where the ventral pancreatic duct encircles the duodenum to join the main pancreatic duct. In the intramural form, the pancreatic tissue penetrates in the muscular layer of the duodenum and the small ducts drain directly into the duodenum.

In about half of the symptomatic patients, it will present with gastrointestinal or biliary duct obstruction in neonates, whereas in adults it will manifest with dyspepsia, duodenal obstruction (in about 10% of cases) or pancreatitis.

On CT and MR, a band of pancreatic tissue is seen encircling the second portion of the duodenum. MR is advantageous because it allows depiction of the main pancreatic duct.[:]

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