Gernigon Y, Lozach P, Blain F, Bellet M, Griffe J
Nouv Presse Med. 1980 Mar 12;9(17):1229-31.
Annular pancreas--a congenital malformation consisting of a ring of pancreatic tissue around the second part of the duodenum--is a rare surgical condition in adults. It may be responsible for occlusion in the newborn, but frequently remains latent or does not reveal itself until adulthood, usually around the age of 40. The only symptoms are ulcer-like epigastric pains; vomiting occurs at a late stage and jaundice irregularly. Hypotonic duodenography shows, at best, duodenal stenosis, the extrinsic origin of which is disclosed by fiberoscopy. Pre-operative investigations should aim at detecting a gastro-duodenal ulcer or an associated chronic pancreatitis. Owing to the presence of an excretory duct within the ring, section of the latter entails a risk of fistulisation. The best prospects of cure are offered by digestive tract derivation procedures: latero-lateral duodeno-duodenostomy, gastro-enterostomy and duodeno-jejunostomy on a Y-shaped excluded jejunal loop.
环状胰腺是一种先天性畸形，由围绕十二指肠第二部的胰腺组织环构成，在成人中是一种罕见的外科病症。它可能导致新生儿肠梗阻，但常常潜伏着，或直到成年期（通常在40岁左右）才显现出来。唯一的症状是类似溃疡的上腹部疼痛；呕吐出现在晚期，黄疸则不规则出现。低张十二指肠造影最多只能显示十二指肠狭窄，纤维镜检查可揭示其外在起源。术前检查应旨在发现胃十二指肠溃疡或相关的慢性胰腺炎。由于环内存在排泄管，切除环会有发生瘘管的风险。消化道改道术提供了最佳的治愈前景：侧侧十二指肠十二指肠吻合术、胃肠吻合术以及在Y形旷置空肠袢上进行十二指肠空肠吻合术。
