Annular pancreas: case report and review of the literature

Annular pancreas is defined as a pancreatic ring which encircles the descending portion of the duodenum. Since its first description in 1818, attention has been paid to this variation due to its clinical manifestations, which may appear in the first days of life or even in adulthood, and usually require surgical treatment. Although an infrequent variation, more and more reports have been published due to new and improved diagnostic techniques, which include magnetic resonance cholangiopancreatography, endoscopic ultrasonography, and endoscopic retrograde cholangiopancreatography. A case of annular pancreas found during routine abdominal dissection of an adult female cadaver is reported here. It consisted of a complete pancreatic ring which surrounded the descending part of the duodenum. The duodenum was clearly distended proximally. After careful dissection, the ring presented a duct with a circumferential direction emptying into the pancreatic duct. The presence of this variation is associated with the embryology of the ventral pancreatic anlage. Clinical, diagnostic and therapeutic implications of this variation are discussed in this article.