Annular pancreas and jaundice

Morrell, M. Tessa; Keynes, W. Milo

doi:10.1002/bjs.1800571105

Cited by 7 publications

(2 citation statements)

References 6 publications

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“…First paper with 15 patients with AP and obstructive jaundice was published by Morrell and Keynes. 23 Out of those patients only 4 were with choledocholithiasis. After then there are several reports of a sporadic cases and very small series of patients with AP and biliary obstruction and none of them were with choledocholithiasis, hence our case is a rare and unique form of presentation of AP.…”

Section: Discussionmentioning

confidence: 98%

Annular pancreas with choledocholithiasis in an adult male patient: a case report

Milev¹,

Karagjozov²,

Mitevski³

et al. 2019

Int Surg J

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Annular pancreas is very rarely presented with a clinical picture of obstructive jaundice, usually due to some biliopancreatic malignancy rather than choledocholithiasis which make our case unique. We are presenting a 60-year-old male patient with a 6 mounts old medical history of right upper quadrant pain and intermittent jaundice. On ultrasonography a common bile duct stone was detected with dilatation of the biliary tree and gallstones with edematous wall of the gallbladder. On gastroscopy narrowing of the duodenum was registered. On ERCP the papilla Vateri could not be cannulated and there was a substantial amount of retained food in the duodenal bulb and antral part of the stomach. MRCP showed extensive dilatation of the whole biliary tree from several stones in the distal part of the common bile duct. At the operation there was a ring of pancreatic tissue about 2 cm wide that surrounded the second portion of the duodenum. The operation proceeded with choledochotomy, choledocholythotomy, L-L choledocho-duodenostomy and partial resection of the pancreatic ring. After three mounts the patient had gain weight, had no pain or any other symptoms and control gastroscopy showed normal finding.

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Section: Discussionmentioning

confidence: 98%

Annular pancreas with choledocholithiasis in an adult male patient: a case report

Milev¹,

Karagjozov²,

Mitevski³

et al. 2019

Int Surg J

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“…Annular pancreas is a congenital anomaly that occurs at a frequency of 1:20,000 births and can manifest with stenotic or obstructive symptoms from the Wrst days of life [1][2][3]. In a few cases the condition may be found in adults [4].…”

Section: Discussionmentioning

confidence: 99%

Annular pancreas in an adult managed by laparobotic surgery: a case report

Chinnappan

Yiengpruksawan

2008

J Robotic Surg

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Annular pancreas in an adult is an uncommon and infrequently reported anomaly which is characterized by the presence of ectopic pancreatic tissue surrounding the descending part of the duodenum. It is one of the few congenital anomalies of the gastrointestinal tract, which can manifest with symptoms late in life (Ravitch and Woods in Ann Surg 132:1116-1127, 1950). In adults, the factors initiating symptoms are recurrent pancreatitis, duodenal stenosis at the site of the annulus, or duodenal or gastric ulceration (Morrell and Keynes in Br J Surg 57:814-816, 1970). Operative management of these cases involves bypassing the obstructed duodenum. Duodenoduodenostomy is routinely performed in neonates and children. We report a case of annular pancreas in a 55-year-old male that was successfully treated with robotic duodenoduodenostomy.

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Annular pancreas in adults: embryological development, morphology and clinical significance

et al. 2002

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Three cases (two male, one female) of annular pancreas are presented, which were found and operated on within the last three decades. Diagnosis was made using imaging techniques, especially ultrasonography and computed tomography. In two cases there was incomplete obstruction, while in the other obstruction was complete. It is characteristic that in the case of complete obstruction the annular portion of the pancreas attached to a circular band of connective tissue, while in the two cases of incomplete obstruction there was a complete ring of pancreatic tissue. In all cases surgical intervention was needed in order to create a bypass. In the first case gastroenterostomy and truncal vagotomy was performed, in the second latero-lateral duodeno-jejunostomy and in the third latero-lateral antropyloroduodeno-jejunostomy. The embryology and morphology of the annular pancreas, the morphology of its duct system, diagnosis, differential diagnosis and the surgical treatment of this rare condition are reviewed.

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Annular pancreas and jaundice

Cited by 7 publications

References 6 publications

Annular pancreas with choledocholithiasis in an adult male patient: a case report

Annular pancreas with choledocholithiasis in an adult male patient: a case report

Annular pancreas in an adult managed by laparobotic surgery: a case report

Annular pancreas in adults: embryological development, morphology and clinical significance

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