Pediatric Annular Pancreas

  • Etiology: Congenital malformation of ring of pancreatic tissue which surrounds second part of duodenum
  • Imaging UpperGI: Narrowing at second part of duodenum
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Always associated with duodenal stenosis or atresia and therefore has high gastrointestinal obstructive symptoms

Radiology Cases of Annular Pancreas

UGI of annular pancreas
Lateral image from an upper GI exam shows complete obstruction at the second part of the duodenum.
AXR and upper GI of annular pancreas
Left lateral decubitus AXR (above left) shows an air filled duodenal bulb and an air filled stomach (double bubble sign) with some distal bowel gas. Transverse US of the pylorus (below left) shows from left to right a fluid filled duodenal bulb, normal pylorus, and fluid filled stomach (double bubble sign). AP image from an upper GI exam (below right) shows a distended stomach and duodenal bulb with the remainder of the duodenal C-loop having a normal caliber.