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2019, Number 2

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Rev Med Inst Mex Seguro Soc 2019; 57 (2)

Annular pancreas, cause of abdominal pain: Case report

Martínez-Bautista P, Aguilar-Mena ME, Barbosa-Cruz X, Vilchis-Chaparro E, Espinoza-Anrubio G, Rodríguez-Elizondo JC

Language: Spanish
References: 17
Page: 118-123
PDF size: 712.76 Kb.


ABSTRACT

Background: Annular pancreas is a congenital abnormality which causes duodenal obstruction in neonates. It befalls upon 1 patient amongst every 12 000- 15 000 newborns. It often appears in adulthood. Clinical traits include abdominal pain, intestinal obstruction, vomiting, and pancreatitis. The diagnosis requires image studies and surgical exploration.
Clinical case: Female patient, 11 years of age, presenting intermittent chronic abdominal pain, underweight for her age. Treated by a private physician with ranitidine (4 mg/kg/day) and ibuprofen (5 mg/kg/dose) orally, for one month, due to acid-peptic disease. On December 31, 2017, she was attended at Pediatric Emergency presenting epigastric pain, and nausea. She vomited bile contents 4 times over a 24 hour span. Other symptoms included painful reaction to epigastric palpation, positive pancreatic points, negative Murphy’s sign, no hepatomegaly or splenomegaly, decreased peristaltic noises. Reported: amylase 2163 U/L, lipase 821 U/L, lactic dehydrogenase 461 U/L. Pancreatic ultrasound: 19.3 mm head, 23.2 mm body and 10 mm tail. She was admitted to pediatrics, where the annular pancreas condition was confirmed through ultrasound and computed tomography scan. She then underwent conservative treatment.
Conclusion: The patient displayed typical annular pancreas symptoms. Image studies were key to the diagnosis.


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