Annular pancreas

  • Second most common congenital anomaly
  • Failure of normal rotation during development
  • Pancreas partially or completely encircles duodenum
  • Sometimes causes symptomatic duodenal narrowing
  • Barium studies show narrowing at level of major papilla
  • Quite often asymptomatic
  • CT, MRI shows the tissue around second part of duodenum
  • ERCP or MRCP will show the duct encircling the duodenum