title: [Anular pancreas--pancreatic resection or duodenal by-pass].
abstract: OBJECTIVE
  To present the authors experience managing anular pancreas and to compare the results found by the authors with the ones found in the literature.
  
  
  METHODS
  A retrospective review of four patients treated at the Departamento de Cirurgia da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul with anular pancreas. The disease was present in three different ages: one in the neonatal age, one in childhood and two in the adulthood. Gastroduodenal obstructive symptoms were the most common. Abdominal pain was present in adult patients. The diagnostic investigation began with radiological studies such as upper gastrointestinal barium series, upper endoscopy and abdominal computed tomographic scan, although all the diagnoses required surgery for confirmation. The duodenoduodenostomy was the treatment of choice in the pediatric patients, and division of the anulus was carried out in the adults.
  
  
  RESULTS
  All patients had symptomatic relief and postoperative recovery. The hospital stay ranged from 9 to 12 days (median 10.5 days). There were no postoperative complications. All patients remain asymptomatic up to now.
  
  
  CONCLUSIONS
  The rare condition of anular pancreas does not allow a more detailed and comparative study. The results of the authors showed that both gastrointestinal by-pass and division of the pancreas are effective and safe treatments.
authors.affiliation: Departamento de Cirurgia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS. mkruel@zipmail.com
authors.forename: Marcelo Kruel
authors.initials: MK
authors.lastname: Schmidt
authors.forename: Alessandro Bersch
authors.initials: AB
authors.lastname: Osvaldt
authors.forename: José Carlos Soares
authors.initials: JC
authors.lastname: Fraga
authors.forename: Eliziane Emy
authors.initials: EE
authors.lastname: Takamatu
authors.forename: Caterine Lúcia Szwec dos Santos
authors.initials: CL
authors.lastname: Fernandes
authors.forename: Luiz
authors.initials: L
authors.lastname: Rohde
mesh_terms: D002648:Child; D004386:Duodenum / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000295:instrumentation