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Complete Annular Pancreas with Concurrent Entero-Pancreatico-Biliary Symptoms in Adult: A Case Report
M M Chowdhury1, A A Ullah, R Karim
1Professor Md Mohsen Chowdhury, Professor & Head, Department of the Yellow Unit II, Hepatobiliary & Pancreatic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Insights
Complete Annular Pancreas (AP) is a rare congenital anomaly. Surgical intervention offers a favorable outcome for adults presenting with biliary, duodenal, or pancreatic symptoms.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
Background:
- Complete Annular Pancreas (AP) is a rare congenital anomaly.
- While often diagnosed in infancy, AP can manifest in adulthood with varied symptoms.
Observation:
- A 43-year-old female presented with concurrent biliary, duodenal, and pancreatic symptoms.
- Laparotomy revealed a complete AP with partial duodenal stenosis and a dilated common bile duct.
Findings:
- Surgical management included gastrojejunostomy and hepaticojejunostomy (Roux-en-Y anastomosis).
- The patient experienced a complete symptom resolution post-surgery.
Implications:
- Complete AP can present at any age with diverse symptomatology.
- Surgical treatment for symptomatic adult AP demonstrates positive outcomes.
Abstract:
Complete Annular pancreas (AP) is a rare congenital anomaly, often presented and operated at the early age of life. Adult presentation group usually presents with either biliary or duodenal or pancreatic symptoms. We report a case of 43 years old female presenting with concurrent enteric, biliary and pancreatic symptoms admitted on April 2016 in Hepatobiliary and Pancreatic Surgery Department of BSMMU, Dhaka, Bangladesh. A complete type of annular pancreas with partial duodenal stenosis and dilated common bile duct was observed during laparotomy. We performed gastrojejunostomy as well as hepaticojejunostomy (Roux-en-Y anastomosis). Patient was discharged in a good symptom free condition. Complete Annular Pancreas can present at any age, with any one or all of the biliary, pancreatic or duodenal symptoms. Surgery is the treatment of choice and has a good outcome.
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