Adult-Onset Annular Pancreas: When to Intervene?

Annular pancreas in adults is a rare congenital abnormality, often detected after the onset of complications or incidentally during autopsy. Diagnosis in adults is challenging due to the similarity of symptoms with other conditions. We report a case of a 55-year-old female who presented with a six-month history of intermittent colicky pain in the epigastric region, radiating to the back, accompanied by periodic nonbilious vomiting. Abdominal examination revealed mild tympany and succussion splash in the epigastric region, with no organomegaly, lumps, or visible peristalsis. The patient was treated successfully with gastrojejunostomy (GJ) and jejunojejunostomy (JJ), leading to a good recovery. This case highlights the importance of considering the annular pancreas in the differential diagnosis of adults presenting with similar symptoms, underscoring the diagnostic challenges faced by radiologists and surgeons.