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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

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


in English, Spanish


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.


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


Congenital Abnormalities; Pancreas; Abdominal Pain; Pancreatitis


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