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A rare cause of proximal intestinal obstruction in adults - annular pancreas: A case report
B Mahdi, S Selim, T Hassen, MM Mongi, CM Fadhel, C Fathi, S Sadok
Pan African Medical Journal , 2011,
Abstract: Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the descending part of the duodenum. It is one of the few congenital anomalies of the gastrointestinal tract which can produce symptoms late in life. In adults, the factors initiating symptoms are recurrent pancreatitis, duodenal stenosis at the site of the annulus, or duodenal or gastric ulceration. We report a new case involving a 24-year-old woman hospitalised for epigastric pain, nausea and vomiting. Radiological examination was consisted with an annular pancreas. At operation a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas, no other congenital anomaly of the intra-abdominal organs was noted. A gastroenterostomy was performed.
Annular pancreas intra operatively discovered: a case report  [cached]
Zeineb Mzoughi,Ben Abid Sadri,Miloudi Nizar,Hentati Hassen
Clinics and Practice , 2011, DOI: 10.4081/cp.2011.e82
Abstract: Annular pancreas is a rare congenital abnormality. This entity can rarely be symptomatic. Patients can present with gastrointestinal obstruction or acute pancreatitis. We report a case with a rich iconography, of an annular pancreas discovered intraoperatively. A 46- year-old woman was operated with the diagnosis of acute cholecystitis with common bile duct stones. At operation, a strip of pancreatic tissue (2 cm) completely encircled the second duodenum. Open cholecytectomy with choledocotomy and stones extractionwas done. Postoperatively, she developed an acute pancreatitis. The post-operative cholangiography showed the annular duct surrounding the second duodenum. Annular pancreas is rare. Symptoms may occur in newborn children. In adults, annular pancreas discovering is radiological or intra operatively.
Annular pancreas producing duodenal obstruction: A case report  [PDF]
Abdesslam Bouassria, Hicham Elbouhaddouti, Ouadii Mouaqit, El Bachir Benjelloun, Abdelmalek Ousadden, Khalid Mazaz, Khalid Ait Taleb
Open Journal of Gastroenterology (OJGas) , 2013, DOI: 10.4236/ojgas.2013.33032
Abstract:

Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.

A Classic Case of Annular Pancreas and its Clinical Implications
Nayak B,Satheesha; Mun Yooi,Ooi;
International Journal of Morphology , 2011, DOI: 10.4067/S0717-95022011000200043
Abstract: annular pancreas is a rare developmental anomaly where the head of the pancreas surrounds the second part of the duodenum like a ring. this may cause the duodenal constriction, obstruction, peptic ulcers and other complications. we saw a classic case of annular pancreas. the head of pancreas surrounded the second part of duodenum completely. however there was no narrowing of the duodenum. the case may be of importance for gastroenterologists, surgeons and radiologists.
Islet Isolation and Transplantation from an Annular Pancreas: A Case Report
Kin T,Shapiro J,Ryan EA,Lakey JRT
JOP Journal of the Pancreas , 2005,
Abstract: CONTEXT: Annular pancreas is an uncommon congenital anomaly formed by a thin band of normal pancreatic tissue encircling the duodenum. CASE REPORT: We report the first case of an islet isolation and transplantation from an annular pancreas. The pancreas together with duodenum was procured from a 32-year-old previously healthy man after diagnosis of brain death. The pancreas including the annular portion was distended well after intraductal collagenase perfusion. A total of 276,064 islet equivalent was recovered and transplanted into a type 1 diabetic patient. CONCLUSIONS: Bearing in mind the shortage of donors, patients with this anomalous condition should not be excluded as potential organ donors.
Solid-Pseudopapillary Tumor of the Pancreas in Adults: A Case Report  [PDF]
Kamil Gulpinar, Suleyman Ozdemir, Erpulat Ozis, Sadik Ersoz
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41014
Abstract: Solid-pseudopapillary tumor of the pancreas (SPTP) is an uncommon low grade exocrine pancreatic malignancy. We represented a 22 years old female with an abdominal mass of 4 years history and symptoms of weakness, loss of appetite, 7 kilograms weight loss and swelling for almost 2 months. She was suspected of pancreatic malignancy due her abdominal ultrasound and CT reports and therefore underwent explorative surgery that revealed a huge pancreatic tumor .The tumor was resected totally and hystopathological examination reported significant components of pancreatic solid pseudopapiller tumor features which was also the final diagnosis.

Annular pancreas associated with duodenal carcinoma  [cached]
Enrico Br?nnimann, Silke Potthast, Tatjana Vlajnic, Daniel Oertli, Oleg Heizmann
World Journal of Gastroenterology , 2010,
Abstract: Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. Duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics.
Stable relocation of the radial head without annular ligament reconstruction using the Ilizarov technique to treat neglected Monteggia fracture: two case reports
Altaf A Kawoosa, Shabir A Dhar, Mohammed Butt, Shareef A Wani, M R Mir, T A Dar
Journal of Medical Case Reports , 2010, DOI: 10.1186/1752-1947-4-344
Abstract: We report two cases of neglected Monteggia fracture dislocation, in two Kashmiri boys aged four and six years. Using ulnar osteotomy with distraction osteogenesis, we were able to relocate the radial head gradually and maintain the reduction without a requirement for open reduction and annular ligament reconstruction.Distraction lengthening and hyperangulation in different planes by use of the Ilizarov technique effectively reduces the radial head without open reduction and annular ligament reconstruction.Giovanni Battista Monteggia first described in 1814 the fracture dislocation now named after him. It represents a link between injuries of the forearm and the elbow [1]. These injuries follow the course of forearm fractures prognostically if recognized and treated early. However these injuries are often missed at the time of initial trauma [2,3].Long-term follow-up of untreated Monteggia fracture dislocations reveals development of premature arthritis, pain, instability, and loss of pronation and supination [4,5]. Thus, it is imperative to treat the neglected fracture as soon as it is diagnosed. Freedman et al. performed reconstructive procedures up to six years after injury [6]. Currently, chronic dislocations are treated by ulnar osteotomy, open reduction of the radial head and reconstruction of the annular ligament [7]. The literature reports excellent results [8,9], but with restricted movement [10,11] and development of complications [12] associated with methods involving open reduction of the radial head, and ulnar ostoetomy with or without annular ligament reconstruction. Hirayama et al., considering the interosseous membrane as the stabilizer of the radial head, described reduction of the radial head by hyperangulation and lengthening of the ulna without reconstruction of the annular ligament [13]. Relocation of the radial head has been successfully achieved by using distraction lengthening and hyperangulation over a uniplanar lengthening device [14].To cre
Acute neuropsychiatric disorders in adolescents and young adults with Down syndrome: Japanese case reports
Akahoshi K, Matsuda H, Funahashi M, Hanaoka T, Suzuki Y
Neuropsychiatric Disease and Treatment , 2012, DOI: http://dx.doi.org/10.2147/NDT.S32767
Abstract: cute neuropsychiatric disorders in adolescents and young adults with Down syndrome: Japanese case reports Case Series (1927) Total Article Views Authors: Akahoshi K, Matsuda H, Funahashi M, Hanaoka T, Suzuki Y Published Date July 2012 Volume 2012:8 Pages 339 - 345 DOI: http://dx.doi.org/10.2147/NDT.S32767 Received: 08 April 2012 Accepted: 19 June 2012 Published: 30 July 2012 Keiko Akahoshi,1 Hiroshi Matsuda,2 Masuko Funahashi,1 Tomoyuki Hanaoka,3 Yasuyuki Suzuki1 1Department of Pediatrics, Tokyo Children’s Rehabilitation Hospital, Tokyo; 2Department of Nuclear Medicine, Saitama Medical University, International Medical Center, Saitama; 3Department of Pediatrics, Bihoro Rehabilitation Hospital, Hokkaido, Japan Background: The aim of this study was to evaluate acute neuropsychiatric disorders in adolescents and young adults with Down syndrome. We report 13 Japanese adolescents or young adults with Down syndrome who developed acute neuropsychiatric disorders including withdrawal, depression, obsessive-compulsive behaviors, and occasional delusions or hallucinations. Methods: The following information was collected from each patient: age at onset of acute neuropsychiatric disorder, complications, signs and symptoms, personality traits before the onset of the acute neuropsychiatric disorder, prescribed medications with their respective doses and the response to treatment, and senile changes observed on magnetic resonance imaging or computed tomography. Results: The mean age at onset of these disorders was 21.2 years. Brain imaging showed almost senile changes; patients responded well to low-dose psychotropic therapy. Patients had an onset at a young age and presented with treatable conditions, although the average age of the onset of Alzheimer’s disease is generally over 40 years of age in patients with Down syndrome. Conclusion: These findings suggest that the pathology of acute neuropsychiatric disorder in patients with Down syndrome may be related to presenile changes; however, these disorders present features and a clinical course that is different from those presented in typical Alzheimer’s disease with Down syndrome.
Case Report: Congenital aganglionic megacolon in Nigerian adults: Two case reports and review of the literature
AA Bakari, BM Gali, AG Ibrahim, HA Nggada, N Ali, D Dogo, AM Abubakar
Nigerian Journal of Clinical Practice , 2011,
Abstract: Congenital aganglionic mega colon (Hirschsprung’s disease) is a motor disorder in the gut, due to a defect in the craniocaudal migration of the neuroblast originating from the neural crest that occurs during the first twelve weeks of gestation, causing a functional intestinal obstruction, with its attendant complications, in infants. Despite modern pediatric practice, with emphasis on early diagnosis, Hirschsprung’s disease is seen in adults in regions where perinatal care is limited. We report two cases of Nigerian adults with longstanding, recurrent constipation, getting relieved by laxatives and herbal enemata, and then presented to our Emergency Department with a history of progressive abdominal distention, colicky pain, occasional vomiting, and weight loss. Per rectal examination revealed a gripping sensation in the rectum, 10cm from the anal verge, with rectal fecal load. Barium enema showed a grossly distended proximal large colon, with high fecal retention, with the transition zone at the middle one-third of the rectum. Due to difficulty in bowel preparation of these patients, emergency laparotomy was done. The first case had a diverting sigmoid colostomy and later had a low anterior resection. The second case had a one-stage procedure. Histology of both the cases showed aganglionosis of the stenotic segment and a normal distal rectum. Both patients had complete resolution of the symptoms, without complications, in a three-year follow-up. The related literatures were reviewed. Hirschsprung’s disease should be considered in adults patient presenting with chronic constipation. Low anterior resection of the rectum would be a surgical option for the treatment of short and zonal segment of adult Hirschsprung’s disease.
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