ABSTRACT
Pancreas divisum (PD) is the most common congenital anomaly of the pancreas. It is caused by a failure of the ventral ductal system to fuse with the distal dorsal ductal system. The association of PD and recurrent acute or chronic pancreatitis is controversial. Ectopic pancreas, or a pancreatic rest, is pancreatic tissue that lacks anatomic or vascular continuity with the pancreas. Annular pancreas presents differently based on age of presentation. Whereas one-half to two-thirds of adult cases of annular pancreas remain asymptomatic and are found incidentally, the majority of children with annular pancreas develop gastric outlet obstruction within the first few days of life. Children with annular pancreas have a higher association with other congenital abnormalities, the most common being down syndrome and congenital heart disease. A diagnosis of annular pancreas is suspected based on prenatal ultrasound or plain abdominal radiographs shortly after birth that demonstrate a classic ‘double bubble’ sign.
