What is annular pancreas?

Annular pancreas is the most common birth defect seen in the pancreas. The pancreas is an organ that plays an important part in your digestive process. The term annular pancreas means that a ring of extra pancreatic tissue covers the first part of your small intestine (duodenum). It goes all the way up to your pancreas. Your pancreas can still function, but the extra tissue can cause a number of symptoms. It can also disrupt your digestive process and other bodily functions.

What causes annular pancreas?

Annular pancreas is a rare birth defect. The cause is not known.

What are the symptoms of annular pancreas?

Annular pancreas is a rare condition. The exact number of people born with it is unknown. Healthcare providers may diagnose the defect in babies, even before birth. But sometimes, it's not recognized and diagnosed until after symptoms start. This could be in childhood or even adulthood. In infants and young children, it can cause intolerance to food, vomiting, and swollen belly. In older children and adults, it can cause similar symptoms and chronic belly pain. Most people with annular pancreas don’t have any symptoms.

Annular pancreas is linked with Down syndrome. About 1/4 of people with this condition also have Down syndrome.

Annular pancreas can lead to other problems, such as peptic ulcer disease, acute or chronic pancreatitis, and jaundice.

How is annular pancreas diagnosed?

Your healthcare provider will do an exam and ask about your health history. Other tests may be done to evaluate whether you have annular pancreas.

An ultrasound may identify the presence of annular pancreas even before a baby is born. If the diagnosis is made later in life, it's often found through an upper GI series X-ray, CT scan, or MRI. These diagnostic scans often identify the tissue that causes a narrowing of the duodenum and air pockets typical of a blockage.

How is annular pancreas treated?

If the condition causes problems, surgery is the typical treatment. The surgery involves bypassing the blockage that the annular pancreas causes. The annular pancreas itself is rarely removed. This would risk injuring the pancreatic tube and causing a leak of fluids within it. A surgeon does the surgery through an incision in the upper part of the belly.

What are possible complications of annular pancreas?

Complications related to annular pancreas include blockage of the duodenum and poor liver function. It can result in pancreatitis, small intestine ulcers, intestinal blockage, and jaundice. In some cases, an abnormal connection between the windpipe and the esophagus can also be associated with an annular pancreas. In rare cases, pancreatic cancer is a complication related to annular pancreas. 

When should I call my healthcare provider?

Call your healthcare provider if you have any prolonged abdominal pain, recurrent nausea or vomiting, or fullness after meals. This could mean you have an annular pancreas as a possible cause. This is particularly true if you also have Down syndrome.

Key points about annular pancreas

• Annular pancreas is the most common defect seen in the pancreas.

• Annular pancreas is caused by a rare birth defect. The developing pancreas does not form correctly.

• The condition is caused by a ring of extra pancreatic tissue that covers the first part of your small intestine.

• If annular pancreas causes symptoms, such as blockage of intestines, abdominal pain, or food intolerance, it can be treated with surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your healthcare provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.