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Rev Med Inst Mex Seguro Soc. 2019 Jul 31;57(2):118-123.

Annular pancreas, cause of abdominal pain: Case report

[Article in Spanish; Abstract available in Spanish from the publisher]

Author information

1
Instituto Mexicano del Seguro Social, Hospital General de Zona con Medicina Familiar No. 8 “Dr. Gilberto Flores Izquierdo”, Especialización en Medicina Familiar. Ciudad de México, México

Abstract

in English, Spanish

Background:

Annular pancreas is a congenital abnormality which causes duodenal obstruction in neonates. It befalls upon 1 patient amongst every 12 000-15 000 newborns. It often appears in adulthood. Clinical traits include abdominal pain, intestinal obstruction, vomiting, and pancreatitis. The diagnosis requires image studies and surgical exploration.

Clinical case:

Female patient, 11 years of age, presenting intermittent chronic abdominal pain, underweight for her age. Treated by a private physician with ranitidine (4 mg/kg/day) and ibuprofen (5 mg/kg/dose) orally, for one month, due to acid-peptic disease. On December 31, 2017, she was attended at Pediatric Emergency presenting epigastric pain, and nausea. She vomited bile contents 4 times over a 24 hour span. Other symptoms included painful reaction to epigastric palpation, positive pancreatic points, negative Murphy’s sign, no hepatomegaly or splenomegaly, decreased peristaltic noises. Reported: amylase 2163 U/L, lipase 821 U/L, lactic dehydrogenase 461 U/L. Pancreatic ultrasound: 19.3 mm head, 23.2 mm body and 10 mm tail. She was admitted to pediatrics, where the annular pancreas condition was confirmed through ultrasound and computed tomography scan. She then underwent conservative treatment.

Conclusion:

The patient displayed typical annular pancreas symptoms. Image studies were key to the diagnosis.

KEYWORDS:

Congenital Abnormalities; Pancreas; Abdominal Pain; Pancreatitis

PMID:
31618567

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