Annular Pancreas

Introduction

• Embyrologic deformity of the pancreas 
• Pancreas normally develops from one dorsal and two ventral buds
• Ventral buds normally rotate with duodenum, but if they fail to do so, annular pancreas may form 
• Three theories to explain this:
  • Adherence of the ventral bud to the duodenal wall prior to rotation, resulting in its persistence and encirclement of the duodenum (Lecco’s theory).
  • Persistence and enlargement of the left ventral bud (Baldwin’s theory).
• Hypertrophy and fusion of the ventral and dorsal buds before rotation of the gut, resulting in complete encirclement of the duodenum.

Presentation

• Symptoms
  • bowel obstruction in a newborn
    • see Bowel obstruction topic