title: Symptomatic annular pancreas in adult: Report of two different presentations and treatments and review of the literature.
abstract: Annular pancreas (AP) in adults is a rare embryologic abnormality detected after development of complications or as incidental finding. Diagnosis and treatment strategies for symptomatic adult AP remain controversial. We describe two different presentation of AP: a woman with a specific upper abdominal pain treated with medical therapy and a man with upper gastroenteric obstructive symptoms which underwent surgical duodeno-jejunal by-pass. English language literature about annular pancreas etiology, diagnosis and treatment was reviewed. No specific guidelines and protocols exist about management of AP, therefore, treatment and operative approaches must be individualized. In consideration of the possible post-operative complications, surgical treatment should be reserved in case of failure of conservative medical therapies.
authors: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Perugia, Italy; University of Perugia, Department of Surgical and Biomedical Sciences, Via G. Dottori, 06100 Perugia, Italy. Electronic address: rondellif@hotmail.com.
authors: Fabio
authors: F
authors: Rondelli
authors: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Perugia, Italy; University of Perugia, Ph.D. School of Biotechnologies, Italy. Electronic address: walterbugiantella@alice.it.
authors: Walter
authors: W
authors: Bugiantella
authors: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Perugia, Italy. Electronic address: paolo.stella@uslumbria2.it.
authors: Paolo
authors: P
authors: Stella
authors: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Perugia, Italy. Electronic address: bonimarce@tiscali.it.
authors: Marcello
authors: M
authors: Boni
authors: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Perugia, Italy. Electronic address: enrico.mariani@yahoo.it.
authors: Enrico
authors: E
authors: Mariani
authors: Radiology, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Perugia, Italy. Electronic address: fcrusco@gmail.com.
authors: Federico
authors: F
authors: Crusco
authors: General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100 Terni, Italy. Electronic address: alessandrosanguinetti@gmail.com.
authors: Alessandro
authors: A
authors: Sanguinetti
authors: General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100 Terni, Italy. Electronic address: apolis74@yahoo.it.
authors: Andrea
authors: A
authors: Polistena
authors: General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100 Terni, Italy. Electronic address: nicolaavenia@libero.it.
authors: Nicola
authors: N
authors: Avenia
keywords: Annular pancreas; Duodenal obstruction; Pancreatic surgery; Pancreatitis