Annular pancreas associated with duodenal carcinoma

Figure 1 Multislice computed tomography. A fluid filled stomach and enlargement of the pancreatic head (arrow) are detected, which encircles the second segment of the duodenum (dotted arrow).

Figure 2 T2 weighted magnetic resonance cholangiopancreatography images depict the aberrant pancreatic duct, which encircles the duodenum and connects with the main pancreatic duct (arrows).

Figure 3 During surgery, a massively distended and elongated first segment (left arrow) and a conic stenosis of the second segment of the duodenum were observed due to the annular pancreas (right arrow).

Figure 4 Eight weeks later, T1 w post contrast axial MR shows dilatation of the common bile duct.

Figure 5 Cross sectional view showing the tumor within the duodenum (asterisk). The duodenum is surrounded by the incomplete annular pancreas (arrows).