Annular pancreas with obstructive jaundice: beware of underlying neoplasm.
BACKGROUND
Annular pancreas is a rare congenital abnormality, and in adult patients it presents with clinical features that differ from those seen in newborns. Features in the adult patient include peptic ulceration, duodenal obstruction, acute pancreatitis, and obstructive jaundice. Treatment strategies for annular pancreas with obstructive jaundice remain controversial.


OBJECTIVE
To present three cases involving adult patients with annular pancreas and obstructive jaundice, due to carcinoma of the ampulla of Vater in two patients and chronic pancreatitis in the third.


RESULTS
Pancreaticoduodenectomy was performed on all patients, and the postoperative courses were uneventful.


CONCLUSIONS
Our experience suggests that for adult patients with annular pancreas presenting with obstructive jaundice, it is necessary to consider the possibility of associated or coexisting periampullary malignancy.
Shan
Yan-Shen
YS
Department of Surgery, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Sy
Edgar D
ED
Lin
Pin-Wen
PW
D000328:Adult; D014670:Ampulla of Vater; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D002908:Chronic Disease; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000150:complications; D014057:Tomography, X-Ray Computed