Chronic Pancreatitis in Annular Pancreas, Presenting with Gastric Outlet Obstruction and Bile Duct Stricture

[摘要] Background: Annular pancreas is an uncommon congenital entity. Its association with chronic pancreatitis, duodenal stenosis, and distal bile duct stricture in adult patient is extremely rare. Case Report: A 38 year female presented with on an off abdominal pain, nausea and vomiting for 4 months.  Imaging revealed chronic pancreatitis with radiological distal common bile duct stricture. Endoscopic evaluation showed narrowing at second part of  duodenum. A thin band of pancreas was encircling the second part of duodenum with other consistent radiological findings. Patient successfully managed by lateral pancreaticojejunostomy, stapler duodenoduodenostomy and Roux-en-Y hepaticojejunostomy. Conclusion: Stricture of distal bile duct and gastric outlet obstruction in chronic pancreatitis is not very uncommon but its association with annular pancreas is extremely rare. However, this entity can be successfully managed with high suspicion and proper evaluation.

[学科分类] 生理学

[关键词] Annular Pancreas;Bile;Duodenal Obstruction;Nausea;Pancreatic Diseases;Vomiting.