Gastric Outlet Obstruction Secondary to Annular Pancreas: A Case Report

Abstract

Annular pancreas is a rare congenital anomaly in which pancreatic tissue encircles the duodenum, potentially causing partial or complete obstruction. It usually presents with duodenal obstruction in neonates and with complex pancreato-biliary complications in adults. This case illustrates an unusual presentation of annular pancreas in a 13-year-old female, complicated with gastric outlet obstruction, antral stricture, and rare pyloric Brunner’s gland hyperplasia. The patient presented with a relatively short four-month history of recurrent non-bilious vomiting, yet had developed marked abdominal distension and massive gastric dilatation with
significant weight loss.

The patient was successfully managed with antecolic gastrojejunostomy with Braun jejunojejunostomy. At two-month follow up, she was clinically well with symptomatic improvement and weight gain. This case highlights that even in the presence of severe anatomical distortion, prompt diagnosis and surgery adapted to patient’s anatomy can yield excellent results.