Annular Pancreas and Concomitant Pancreatic Divisum in a Symptomatic Adult: A Rare Indication for Pancreaticoduodenectomy

Context: Of the congenital pancreatic anomalies, divisum is most common. Its prevalence thought to be roughly 10%. Less common annular pancreas, with data estimating its presence in only 1 out of 1000 individuals. The pancreas and concomitant has been identified up 50% cases. Though many patients this diagnosis remain asymptomatic, occasionally it may present adulthood. When symptoms are life-altering, surgical intervention warranted. Case Report: A 39-year-old female who suffered from abdominal pain, nausea vomiting for her life was have an pancreas. progressed, resulting 30-pound unintentional weight loss, she evaluated by Hepatopancreaticobiliary surgery. Additional imaging divisum. patient underwent a pylorus preserving pancreaticoduodenectomy omental free flap. Intraoperatively, complete visualized (Image 1). Pathology confirmed major minor papillae 2.6cm apart histologic evidence underlying chronic pancreatitis. patient’s hospital course unremarkable discharged home on postoperative day seven. She since had resolution symptoms. Conclusion: Both uncommon anomalies. They coexist patients. While asymptomatic majority individuals, can rarely during adulthood severe debilitating In these patients, offers solution their