Adult presentation of symptomatic annular pancreas treated with gastrojejunostomy.

Annular pancreas is a rare congenital abnormality that is often considered a neonatal condition, though in few cases it can present in adulthood. Patients diagnosed with annular pancreas in adulthood are often asymptomatic and diagnosed incidentally from radiologic studies. While there is no existing treatment protocol for symptomatic annular pancreas, multiple surgical approaches have been documented in the literature. In this case study we present a 49-year-old female patient who presented with gastric outlet obstruction secondary to annular pancreas. The patient was treated with nasogastric decompression and open side-to-side gastrojejunostomy with an antecolic approach to bypass the obstructed duodenal segment. The surgery was successful, followed by an uneventful postoperative course and discharge on postoperative Day 4. By 5-week outpatient follow-up the patient had resolution of her symptoms and achieved weight gain.