Pancreas organogenesis is regulated by the interaction of distinct signaling pathways that promote or restrict morphogenesis and cell differentiation. Previous work has shown that activin, a TGF(beta+) signaling molecule, permits pancreas development by repressing expression of Sonic hedgehog (Shh), a member of the hedgehog family of signaling molecules that antagonize pancreas development. Her...

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-a...

A 67-year-old female presented to the emergency department with epigastric and left-upper-quadrant abdominal pain. The patient reported history of multiple episodes of abdominal pain similar in nature over the last 2 years. Computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen demonstrated acute pancreatitis along with the presence of pancreatic tissue around the descendi...

BACKGROUND Neonatal diabetes mellitus is a rare condition. CASE CHARACTERISTICS A small for gestational age male, presented with neonatal onset diabetes mellitus, duodenal atresia, annular pancreas and gall bladder hypoplasia. OBSERVATION Observation: A novel homozygous mutation p.K163R (c.488A>G) in the PDX1 gene was found. Parents were heterozygous for the same. MESSAGE This case highli...

Lim J, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-219839 Description A 35-year-old man was admitted following daily vomiting for 2 weeks. He reported bouts of unexplained vomiting over the preceding 10 years. Gastroscopy showed obstruction in the second part of the duodenum with normal mucosa on biopsy (figure 1). CT demonstrated dilation of the first part of the duodenum caused by narrowin...

Annular pancreas is a rare congenital anomaly that is usually diagnosed in newborns. Its diagnosis in adults is uncommon and is one of the few congenital anomalies of the gastrointestinal tract that can debut with symptoms in adults. We present the case of a 65-year-old woman who reported ongoing dyspepsia and vomiting episodes over the prior 2–3 months. Gastroscopy demonstrated stenosis of the...