Image Based Question – 72030

Regarding this condition as shown in the image,what is the treatment of choice?

A. Division of pancreas

B. Duodenoduodenostomy

C. Duodenojejunostomy

D. Bilroth II gastrectomy

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Correct Answer » C Explanation

Ans:C. Duodenojejunostomy

Annular Pancreas is shown in the image.

ANNULAR PANCREAS

• Due to failure of complete rotation of the ventral pancreatic bud during development, so that a ring of pancreatic tissue surrounds the second or third part of the duodenum.The histology of pancreatic tissue is normal.

• Most often seen in association with congenital duodenal stenosis or atresia.

• More prevalent in children with Down’s syndrome

• Duodenal obstruction typically causes vomiting in the neonate.

• X-ray- Dilated stomach and dilated duodenum i.e., (double bubble sign).

• The usual treatment is bypass (duodenoduodenostomy)

• The disease may occur in later life as one of the causes of pancreatitis, in which case resection of the head of the pancreas is preferable to lesser procedures