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Annular pancreas in a 24-year-old woman with persistent abdominal pain
  1. Randolph de la Rosa Rodriguez1,
  2. Alexandra Fogarty2,
  3. Gary M Israel3 and
  4. Mayra J Sanchez1
  1. 1 Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2 Neurology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA
  3. 3 Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr Randolph de la Rosa Rodriguez, randolph.delarosarodriguez{at}


Annular pancreas (AP) is a rare diagnosis in the adult population but can cause significant morbidity if not correctly identified. In adults, the most common symptoms are abdominal pain, nausea and vomiting. While these are not specific to AP, they are important clues to this diagnosis in the right clinical context. We present the case of a 24-year-old woman presenting with a 6-year history of progressive abdominal pain and dyspepsia in the context of an extensive negative workup. Upper gastrointestinal (GI) series and MRI revealed partial duodenal obstruction, concerning for AP. While patients with chronic abdominal pain and vague GI complaints may be diagnosed with functional bowel disorders, it is important to appropriately address the possibility of an underlying structural lesion such as AP. This strategy is not only cost-effective but also saves the patient discomfort associated with unnecessary procedures and allows a timely intervention.

  • pancreas and biliary tract
  • gastrointestinal system

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  • Contributors RdlRR and AF made a chart review and acquisition of patient’s data. GMI interpreted the radiology images and provided good quality pictures for the report. MJS participated in concept creation, design and discussion. Article guarantor: MJS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed

  • Patient consent for publication Obtained.

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