Snapshot quiz 12/13
Authors: Lodewick TM and Dejong CHC
This 72-year-old man underwent laparotomy because of a pancreatic head tumour. The encircling of the descending part of the duodenum by the pancreas is also known as ‘pancreas annulare’ and is caused by an abnormal embryological development. The incidence of this rare anomaly is uncertain as the vast majority probably remain asymptomatic. Pancreatic tissue surrounding the duodenum is histologically normal. However, due to a higher incidence of pancreatitis, there is an increased risk of developing a malignancy. Surgical management of malignancies in the annular pancreas is identical to that in the normal pancreas.