[Anular pancreas--pancreatic resection or duodenal by-pass].
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.
Schmidt
Marcelo Kruel
MK
Departamento de Cirurgia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS. mkruel@zipmail.com
Osvaldt
Alessandro Bersch
AB
Fraga
José Carlos Soares
JC
Takamatu
Eliziane Emy
EE
Fernandes
Caterine Lúcia Szwec dos Santos
CL
Rohde
Luiz
L
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