An annular pancreas is a rare congenital deformity (one that you are born with) that affects the pancreas. It happens when your pancreas doesn’t develop as it should. Instead, a ring of extra pancreatic tissue forms around the first part of your small intestine. It surrounds the duodenum (the wide, short part of the small intestine) and goes all the way to the pancreas. Doctors have yet to find out why this happens, although it only affects 5 to 15 babies out of 100,000 births.
Experts think that the problem is caused by incomplete rotation of the ventral pancreatic bud. The function of the pancreas is to release insulin to turn glucose into energy. It also makes enzymes that aid in digestion.
Although the pancreas can still perform its role, the extra tissue can cause problems. It blocks the duodenum, leading to poor food digestion.
Symptoms of Annular Pancreas
The symptoms of annular pancreases are not commonly known. This is because the condition is rare, and experts don't know how many people are born with it. However, sometimes doctors may discover the defect before a child is born and in newborn babies. A prenatal ultrasound helps to detect the condition. They may also see signs of intestinal blockages in newborns.
In other cases, the condition isn’t recognized or diagnosed until after symptoms start to show in childhood or adulthood.
In infants and younger children, the condition can have symptoms like:
- Food intolerance, with infants spitting up more than normal
- Swollen belly
- Vomiting
- Chronic belly pain
- Too few bowel movements
The condition is also closely linked to Down syndrome. It may also lead to other problems like jaundice, acute or chronic pancreatitis, and peptic ulcer disease.
Diagnosis of Annular Pancreas
When you have an annular pancreas, your doctor will want to know about your medical history. They will be interested to know about any congenital problems you may have had in the past. For an accurate diagnosis, your doctor will perform several tests to confirm the condition.
Tests to help diagnose if you have an annular pancreas include:
- Ultrasound of your abdomen
- Computed tomography (CT) scan
- Small bowel series
- Magnetic resonance imaging (MRI) of your abdomen
- X-ray of your abdomen
An annular pancreas falls into categories depending on it how it looks:
- A complete annular pancreas: the annular duct appears to surround the second part of your duodenum.
An incomplete annular pancreas: the ring doesn’t completely surround your duodenum and instead gives it a ‘crocodile jaw’ appearance.
Possible Complications of Annular Pancreas
The annular pancreas can cause problems like:
- Blockage of your duodenum
- Poor liver function
- Ulcers in your small intestines
- Jaundice, when your skin and the whites of your eyes turn yellow.
- An abnormal connection between your esophagus and windpipe
- Pancreatic cancer
If you have abdominal pain that doesn't seem to go away or trouble swallowing, see your doctor for a diagnostic test of the annular pancreas.
Treatment of Annular Pancreas
Treatment is considered only if you have symptoms.Before your doctor recommends treatment, they will consider things like:
- Your overall current and past health
- Your age
- The extent of the condition
- How well your body handles specific medicines, therapies, and procedures
- How long they expect the condition to last
- Your preferred treatment option
In most cases, your doctor will recommend surgery. During the procedure, the surgeon will remove the block the annular pancreas causes to allow the small intestines to function normally. It's not possible to remove the pancreatic tissue from the duodenum because if the tissue is damaged, the pancreas will also suffer the same fate. This is why just the block is removed.
Surgical options to treat the condition include duodenojejunostomy and gastrojejunostomy. Both surgeries require the surgeon to cut the intestine at the point where the pancreas tissue blocks the intestine.
A reconnection is later done to join the two parts of the intestine just below the area of the block. The procedures are preferred treatment options for duodenum compression. They are minimally invasive.
You can resume your regular eating habits after surgery once your normal bowel movements return. Newborns may not be able to lie on their stomachs for several days following the surgery. The time it takes to recover depends on the severity of the condition and your overall health.
Prevention of Annular Pancreas
There's no possible way to prevent the annular pancreas from happening. It's a condition that happens during development in the womb. However, you can take steps to ensure you have a healthy pregnancy for a healthy baby.
Some things you can do to help you have a healthy pregnancy and baby are:
- Make sure you keep up with a healthy diet, including fruits, whole grains, and vegetables.
- Visit your doctor regularly for prenatal checkups.
- Don’t smoke.
- Don't take over-the-counter medications.
- Avoid alcohol.
- Stay hydrated.
