Annular pancreas (ultrasound)

Case contributed by Dr Maulik S Patel


The patient presented with left-sided abdominal colic with dysurea for the last few hours. There was an incidental finding during the ultrasound.

Patient Data

Age: 20 years
Gender: Female

There is an 'echogenic focus' in short-axis images of the pancreas head. Multiple images show the presence of air as well as fluid in this focus. Long axis images show elongation of the focus with extension cranial as well as caudal to the pancreas. The structure in the head of the pancreas is the 2nd part of the duodenum. When its lumen is collapsed, it appears as an 'echogenic focus' in the pancreatic head. The patient was examined after water intake in the right/ left decubitus position. This results in air/ fluid in the duodenum. Pancreatic parenchyma encircles the 2nd part of the duodenum. There is normal pancreatic parenchyma without dilatation of the main pancreatic duct/ common bile duct.

There is left vesicoureteric junction calculus (3-4 mm) causing left-sided mild back pressure changes.

Case Discussion

The patient presented with left-sided ureteric colic. The ultrasound shows left vesicoureteric junction calculus was present.  

There is an incidental finding of the complete annular pancreas.

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