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Annular pancreas with obstructive jaundice: beware of underlying neoplasm
Yan-Shen Shan1, Edgar D Sy, Pin-Wen Lin
1Department of Surgery, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Insights
Annular pancreas in adults can cause obstructive jaundice. In these cases, it is crucial to rule out periampullary malignancy, such as ampullary carcinoma, alongside conditions like chronic pancreatitis.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Congenital Abnormalities
Background:
- Annular pancreas is a rare congenital anomaly presenting differently in adults versus newborns.
- Adult symptoms include peptic ulceration, duodenal obstruction, acute pancreatitis, and obstructive jaundice.
- Treatment for annular pancreas with obstructive jaundice is debated.
Observation:
- This study details three adult cases of annular pancreas with obstructive jaundice.
- Two cases involved carcinoma of the ampulla of Vater.
- One case was associated with chronic pancreatitis.
Findings:
- All three patients underwent pancreaticoduodenectomy.
- Postoperative recovery for all patients was uneventful.
Implications:
- Adult annular pancreas with obstructive jaundice warrants investigation for coexisting periampullary malignancy.
- Early diagnosis and surgical intervention are key for favorable outcomes.
Introduction:
Annular pancreas is a rare congenital abnormality, and in adult patients it presents with clinical features that differ from those seen in newborns. Features in the adult patient include peptic ulceration, duodenal obstruction, acute pancreatitis, and obstructive jaundice. Treatment strategies for annular pancreas with obstructive jaundice remain controversial.
Aim:
To present three cases involving adult patients with annular pancreas and obstructive jaundice, due to carcinoma of the ampulla of Vater in two patients and chronic pancreatitis in the third.
Methodology And Results:
Pancreaticoduodenectomy was performed on all patients, and the postoperative courses were uneventful.
Conclusion:
Our experience suggests that for adult patients with annular pancreas presenting with obstructive jaundice, it is necessary to consider the possibility of associated or coexisting periampullary malignancy.