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Journal of Case Reports
Chronic Pancreatitis in Annular Pancreas, Presenting with Gastric Outlet Obstruction and Bile Duct Stricture
Ashok Kumar, Manas Agarwal, Nishant Malviya  
Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, Uttar Pradesh, India.
Corresponding Author:
Dr Ashok Kumar
Email: drashok97@gmail.com
Received: 29-MAR-2020 Accepted: 28-MAY-2020 Published Online: 15-JUN-2020
DOI: http://dx.doi.org/10.17659/01.2020.0032
Background: Annular pancreas is an uncommon congenital entity. Its association with chronic pancreatitis, duodenal stenosis, and distal bile duct stricture in adult patient is extremely rare. Case Report: A 38 year female presented with on an off abdominal pain, nausea and vomiting for 4 months.  Imaging revealed chronic pancreatitis with radiological distal common bile duct stricture. Endoscopic evaluation showed narrowing at second part of  duodenum. A thin band of pancreas was encircling the second part of duodenum with other consistent radiological findings. Patient successfully managed by lateral pancreaticojejunostomy, stapler duodenoduodenostomy and Roux-en-Y hepaticojejunostomy. Conclusion: Stricture of distal bile duct and gastric outlet obstruction in chronic pancreatitis is not very uncommon but its association with annular pancreas is extremely rare. However, this entity can be successfully managed with high suspicion and proper evaluation.
Keywords : Annular Pancreas, Bile, Duodenal Obstruction, Nausea, Pancreatic Diseases, Vomiting.
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