Q) All are true about annular pancreas except ( AIIMS GI Surgery Question bank)
a) They are mostly asymptomatic
b) It has equal incidence in children and adults
c) Treatment of choice is duodenojejunostomy
Annular pancreas is a congenital malformation but manifestations can appear in the adult life.
Annulus means a ring of pancreatic tissue around the duodenum. For annular pancreas to be diagnosed, this ring can be complete or incomplete.
Normally the ventral buds of pancreas and dorsal bud fuses together. Non rotation and fusion of these two leads to the formation of annular pancreas. It envelops the duodenum.
Age of presentation
Incidence is equal in both adults and children
Presentation in children is congenital anomalies and dudenal obstruction
Presents in adults as pancreatitis usually in 3rd or 4th decade
Association with other pancreatic conditions
1. Pancreas divisum 35- 40%
2. Chronic pancreatitis 45- 50%
It is duodenal bypass and not resection of duodenum as duodenum excision can lead to pancreatitis
in children its duodeno - duodenostomy
in adults duodenoduodenostomy which has now replaced duodenojejunostomy