What Is Annular Pancreas?
The disease of annular pancreas is a rare genetic disorder, where a circle of pancreatic tissue is wrapped around the duodenum (the initial segment of the small intestine). This surrounding tissue has the ability to squeeze or constrict the intestine resulting in feeding and digestion issues. Others are asymptomatic whereas others particularly babies might need surgery to remove the blockage.
Common Causes and Risk Factors
- Congenital birth defect : the pancreas develops around the duodenum instead of alongside it
- Family history : genetic predisposition may play a role
- Associated anomalies : frequently occurs with duodenal atresia or other gastrointestinal defects
- Polyhydramnios in pregnancy : excess amniotic fluid due to impaired fetal swallowing
Signs and Symptoms
- Green or yellow vomiting in newborns
- Poor feeding or failure to thrive in infants
- Abdominal swelling or pain in older children and adults
- Heartburn, indigestion or reflux symptoms
- Excess amniotic fluid detected on prenatal ultrasound
How Dr. Rishi Diagnoses Annular Pancreas?
Dr. Chadha uses a step-by-step approach:
Medical History and Physical Exam
He examines your symptoms, history of growth (in infants), feeding habits, and he conducts a targeted abdominal physical examination to find out the evidence of obstruction and reflux.
Blood Tests
We will screen deficiencies of the nutritional status and exclude other gastrointestinal or metabolic causes of vomiting and poor weight gain.
Imaging Studies
- CT Scan - Provides a clear view of the pancreatic tissue encircling the duodenum and any associated narrowing.
- Abdominal Ultrasound/ MRI - Provides further information particularly in infants or where radiation exposure is a worrying aspect.
Prenatal Ultrasound (When Applicable)
Polyhydramnios or duodenal dilation in uterus on fetal ultrasound would cause a premature suspicion of annular pancreas.
Frequently Asked Questions
What is the cause of the annular pancreas?
It is an inborn defect of the body whereby the pancreas is made up of a ring of tissue that surrounds the duodenum rather than being developed on one side of the body.
What are the symptoms?
Such symptoms are common and include vomiting (which is usually green or yellow), difficulty feeding/weight gain in infants, belly pain, bloating, heartburn or indigestion in older children and adults.
How is it diagnosed?
Diagnosis is generally through a medical history and physical examination, laboratory tests, and a CT scan. Ultrasound or MRI can be utilized to further explain and prenatal ultrasound can identify danger signs in the womb.
What is the distinction between a duodenal atresia and annular pancreas?
Annular pancreas is a squeezing of the duodenum which can be leaked but duodenal atresia is a total obstruction of the duodenum.
What does a CT scan show?
A CT scan can result in a clear view of the ring of pancreatic tissue surrounding the duodenum and any resulting constriction or blockage of the intestinal passage.
Is it able to cause polyhydramnios during pregnancy?
Yes. When the pancreatic ring obstructs the duodenum of the fetus, the infant can not swallow enough amniotic fluid and this will cause too much fluid in the womb.
Which are the treatment options?
It can be treated with dietary changes and drugs (acid reducers, digestive enzymes) or less invasives (endoscopic stenting) or surgery (laparoscopic bypass or open surgical bypass) depending on the severity.
What is the length of time it takes to recover after surgery?
The majority of patients spend 2-5 days in the hospital, and with time, they begin to eat again and in a few weeks, they are on normal diet.
Is it possible to alleviate the symptoms by dietary modification?
Yes. Natural foods with low fat like soft food consumed in smaller and frequent doses and non-spicy carbonated beverages can alleviate pain and enhance digestion.