Annular Pancreas: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Annular Pancreas?
A pediatric surgeon (a children's surgeon) usually treats an annular pancreas. A gastroenterologist (a digestive system doctor) may also help. A pediatrician (a children's doctor) often first checks a newborn who is not feeding well. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is an annular pancreas?
An annular pancreas is a ring of pancreatic tissue that encircles the duodenum. The duodenum is the first part of the small intestine. The normal position of the pancreas is next to the duodenum. It does not surround it. So the ring squeezes and narrows the small intestine. Food then cannot pass easily or at all.
An annular pancreas is a problem present at birth (congenital defect). Doctors describe it as a distinct form of duodenal atresia. Atresia means a passage that did not fully form.
Symptoms
Newborns may not feed well. They may spit up more than normal. They may not drink enough breast milk or formula. They may also cry. Newborns may also have symptoms of complete blockage of the intestine.
Adult symptoms may include:
- Abdominal pain.
- Fullness after eating.
- Nausea or vomiting.
However, up to one half of people with this condition do not have symptoms until adulthood. There are also cases that are not detected because the symptoms are mild.
Causes and who gets it
An annular pancreas is a problem present at birth. Conditions that may be associated with it include:
- Down syndrome.
- Excess amniotic fluid during pregnancy (polyhydramnios).
- Other congenital gut problems, which are present at birth.
- Pancreatitis, or inflammation of the pancreas.
It can affect newborns and adults. Some cases are not detected because the symptoms are mild.
How doctors diagnose it
Tests include an abdominal ultrasound, an abdominal x-ray, and an abdominal CT scan. An ultrasound uses sound waves to make pictures. A CT scan makes detailed pictures of the inside of the body.
Doctors may also order an upper GI and small bowel series. This is a set of x-rays taken to examine the esophagus, stomach, and small intestine. For this test, you drink a chalky liquid called barium. Barium is a substance that shows up well on x-rays.
Treatment
Treatment most often involves surgery to bypass the blocked part of the duodenum. The outcome is most often good with surgery.
When to see a doctor
Contact your health care provider if you or your child has any symptoms of annular pancreas. Call 911 (or your local emergency number) right away if a newborn will not feed and keeps vomiting. This may be a complete blockage of the intestine. Call 911 for anyone with severe belly pain or pressure, severe or lasting vomiting, or vomiting of blood. Adults with an annular pancreas are at increased risk for pancreatic or biliary tract cancer. Milder symptoms that keep coming back also need a doctor visit.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Your doctor can keep track of feeding, growth, or belly symptoms over time. They can also coordinate care with the surgeon and the digestive specialist.
Common questions
Is an annular pancreas present at birth?
Yes. It is a problem present at birth (congenital defect). However, up to one half of people with this condition do not have symptoms until adulthood.
How is an annular pancreas found?
Tests include an abdominal ultrasound, an abdominal x-ray, an abdominal CT scan, and an upper GI and small bowel series.
What is the treatment?
Treatment most often involves surgery to bypass the blocked part of the duodenum. The outcome is most often good with surgery.
Is an annular pancreas linked to other problems?
It may be linked with Down syndrome, extra amniotic fluid in the womb, other gut problems a baby is born with, and pancreatitis.
Sources
- MedlinePlus - Annular pancreas
- NIH Genetic and Rare Diseases Information Center - Annular pancreas
- MedlinePlus - Upper GI and small bowel series
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
