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September 1963

Annular Pancreas and Duodenal Obstruction in the Neonate: A Review

Author Affiliations

From the Department of Surgery, Lloyd Noland Hospital.

Arch Surg. 1963;87(3):379-383. doi:10.1001/archsurg.1963.01310150015004

Annular pancreas is a condition in which pancreatic tissue forms a partial or complete ring encircling the descending duodenum. The condition may manifest itself in infancy, childhood, or adult life. It is an unusual cause of duodenal obstruction in the neonatal period. A recent patient with annular pancreas presenting as duodenal obstruction in a newborn infant has prompted this review of neonatal operative cases.

Tiedemann1 is frequently given credit for the first description of annular pancreas. However, Ravitch and Woods,2 after reviewing Tiedemann's original article, have credited Ecker with the first description of the anomaly in humans.

Pathology-Embryology3-4  The pancreas develops as dorsal and ventral out-pouchings from the entodermal lining of the foregut at the 3-4 mm stage. The dorsal anlage, growing more rapidly than the ventral bud, forms the body, tail, and part of the head of the pancreas. The ventral anlage is carried away from