Annular pancreas, cause of abdominal pain: Case report

Introduccion: el pancreas anular es una anomalia congenita que causa obstruccion duodenal en el neonato. Se reporta en 1 por cada 12 000-15 000 recien nacidos, a menudo se revela en la edad adulta. Clinicamente incluye obstruccion intestinal, dolor abdominal, vomitos y puntos pancreaticos positivos. El diagnostico requiere estudios de imagenologia y exploracion quirurgica. 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: la paciente presento sintomas tipicos del pancreas anular, su estudio mediante imagenes fue decisivo para establecer el diagnostico.