Annular pancreas: A rare cause of duodenal obstruction in elderly

Abstract

Pancreas annulare is a rare congenital anomaly in which a band of pancreatic tissue partially or completely encloses the second part of the duodenum. The anomaly may be asymptomatic throughout life; when symptomatic, it may manifest as pancreatitis, peptic ulcer, duodenal obstruction, or rarely, extrahepatic biliary obstruction. We report a patient aged 74 years who presented with signs of gastric outlet obstruction. The diagnosis was confirmed preoperatively by computed tomography as duodenal stenosis due to a annular pancreas and was successfully treated with surgical duodenojejunostomy. Only a few similar cases have been described in the published medical literature. This case highlights the need to think beyond the common causes of gastric outlet or duodenal obstruction. In addition, cross-sectional abdominal imaging has become an inevitable tool in diagnosing and treating abdominal pathologies, allowing accurate diagnosis and planned surgical interventions.