Annular pancreas as a rare cause of gastric outlet obstruction in a 16-year-old male patient: A case report

Abstract

Annular pancreas (AP) is a rare cause of congenital gastric outlet obstruction that is usually discovered during the neonatal period, but clinical severities can vary over a wide range and definite diagnosis could be delayed until late childhood or adulthood. We report here a case of AP detected in a 16-year-old malnourished male patient who was admitted because of non-bilious vomiting and epigastric fullness after intake of food which was relieved after vomiting. A contrast-enhanced CT scan of the abdomen confirmed the diagnosis of AP. At operation, a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas. No other congenital anomaly of the intra-abdominal organs was noted. He successfully underwent retro-colic gastro-jejunostomy with uneventful postoperative recovery. Though a rare finding, AP should be considered as a differential diagnosis in patients presenting with gastric outlet obstruction after excluding common causes. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.