cause of annular pancreas?

[jughead00]

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what is it?

 

[Big Baller]

Due to malformation and malposition I believe.
On the XRay, you would see double bubble sign and it is also known as bifid ventral pancreatic bud.

 

[jughead00]

Due to malformation and malposition I believe.
On the XRay, you would see double bubble sign and it is also known as bifid ventral pancreatic bud.

thanks! i saw a qs on that topic specifically on UW but i forgot the answer :s

 

[Greenbayslacker]

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[jughead00]

How would you differentiate between this and duodenal atresia?

i think through CT?? not through vomiting tho coz both will have bilious vomiting!

 

[Greenbayslacker]

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[Big Baller]

That is true. They both would have double bubble sign but duodenal atresia is mostly associated with Down Syndrome so they would mention some history of that.

 

[HopeTo99]

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[Big Baller]

Annular pancreas occurs because the ventral and dorsal pancreatic buds fail to fuse properly in the embryo (remember that one of them has to rotate around the duodenum in order to join the other to form the pancreas but this process is interrupted in this case and occludes the duodenum). Duodenal atresia is when the lumen fails to recanalize - so in effect, both pathologies produce bilious vomiting since there is narrowing of the duodenal lumen as a result making it impossible to distinguish between them based on symptoms alone.

I think you meant pancreas divisum. The above mentioned mechanism is not for annular pancreas.

 

[Jamiu22]

That is true. They both would have double bubble sign but duodenal atresia is mostly associated with Down Syndrome so they would mention some history of that.

You are right, the history would most likely guide you to the answer..in both cases the main pathology is food can't pass the duodenum to the stomach, so they would present exact same way... with predisposition to pancreatitis since its juices can't be emptied. But I look at it like this, Duodenal atresia will most likely be complete blockage while annular pancreas will be partial blockage - so in real life, Duodenal atresia will most likely show up on the 1st day of life, while annular pancreas may not show up on the first day.

As for the boards is concerned though... DA question stem would probably include something like epicanthal folds, increase in bHCG, and decrease in AFP.

 

[blaqmamba]

You are right, the history would most likely guide you to the answer..in both cases the main pathology is food can't pass the duodenum to the stomach, so they would present exact same way... with predisposition to pancreatitis since its juices can't be emptied. But I look at it like this, Duodenal atresia will most likely be complete blockage while annular pancreas will be partial blockage - so in real life, Duodenal atresia will most likely show up on the 1st day of life, while annular pancreas may not show up on the first day.

As for the boards is concerned though... DA question stem would probably include something like epicanthal folds, increase in bHCG, and decrease in AFP.

That's the key way to differentiate on an exam if not given Down Syndrome info. Many people can live long lives without even knowing they have an annular pancreas