Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal ad...Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. Duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics.展开更多
BACKGROUND Annular pancreas(AP)is a rare congenital abnormal rotation of the pancreas.AP rarely occurs in adults.Pancreatic tumors and ampullary tumors are related to AP,so the discovery and treatment of AP are essent...BACKGROUND Annular pancreas(AP)is a rare congenital abnormal rotation of the pancreas.AP rarely occurs in adults.Pancreatic tumors and ampullary tumors are related to AP,so the discovery and treatment of AP are essential.CASE SUMMARY This study investigated the clinical manifestations,imaging features,complications,and treatment of six patients diagnosed with AP at the Department of Hepatobiliary and Pancreatic Surgery,First Hospital of Jilin University from January 2010 to June 2020.There were four males and two females,with an average age of 56.00±9.86 years old.In this study,abdominal pain and jaundice were the main clinical manifestations.Imaging can show the“crocodile jaw sign”or“double bubble sign”.CONCLUSION For patients with duodenal or biliary obstruction,physicians should give priority to AP when imaging examinations suggest that the duodenum is wrapped with tissue similar to the density of the pancreas.Symptomatic patients should actively undergo surgical treatment.展开更多
Annular pancreas is a congenital anomaly which .consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It was first described by Tiedemann in 1818 and named ...Annular pancreas is a congenital anomaly which .consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It was first described by Tiedemann in 1818 and named ＂annular pancreas＂ by Ecker in 1862. The first surgical treatment of obstructive annular pancreas was performed on a neonate by Vidal et al in 1905. In the past, the diagnosis of this anomaly was usually made by surgery or autopsy. With the widespread use of endoscopic retrograde cholangiopancreatography （ERCP） and magnetic resonance cholangiopancreatography （MRCP）, more cases are diagnosed preoperatively. We reported two adult cases of annular pancreas with unsuccessful ERCP because of obstruction above the Vater＇s papilla and undefinitive diagnostic MRCP, and discussed its clinical characteristics of this anomaly.展开更多
文摘Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. Duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics.
文摘BACKGROUND Annular pancreas(AP)is a rare congenital abnormal rotation of the pancreas.AP rarely occurs in adults.Pancreatic tumors and ampullary tumors are related to AP,so the discovery and treatment of AP are essential.CASE SUMMARY This study investigated the clinical manifestations,imaging features,complications,and treatment of six patients diagnosed with AP at the Department of Hepatobiliary and Pancreatic Surgery,First Hospital of Jilin University from January 2010 to June 2020.There were four males and two females,with an average age of 56.00±9.86 years old.In this study,abdominal pain and jaundice were the main clinical manifestations.Imaging can show the“crocodile jaw sign”or“double bubble sign”.CONCLUSION For patients with duodenal or biliary obstruction,physicians should give priority to AP when imaging examinations suggest that the duodenum is wrapped with tissue similar to the density of the pancreas.Symptomatic patients should actively undergo surgical treatment.
文摘Annular pancreas is a congenital anomaly which .consists of a ring of pancreatic tissue partially or completely encircling the descending portion of the duodenum. It was first described by Tiedemann in 1818 and named ＂annular pancreas＂ by Ecker in 1862. The first surgical treatment of obstructive annular pancreas was performed on a neonate by Vidal et al in 1905. In the past, the diagnosis of this anomaly was usually made by surgery or autopsy. With the widespread use of endoscopic retrograde cholangiopancreatography （ERCP） and magnetic resonance cholangiopancreatography （MRCP）, more cases are diagnosed preoperatively. We reported two adult cases of annular pancreas with unsuccessful ERCP because of obstruction above the Vater＇s papilla and undefinitive diagnostic MRCP, and discussed its clinical characteristics of this anomaly.
