Annular pancreas in a patient with malignant obstructive jaundice: A case report

Majority of cases with annular pancreas are asymptomatic. Common presentations in symptomatic patients are abdominal pain, nausea and vomiting. Jaundice is very rare presentation of annular pancreas. We are presenting a case of 40 years male with annular pancrea. He presented with jaundice, anorexia and weight loss. Contrast enhanced computed tomography shows annular pancreas with extrahepatic as well as intrahepatic bile duct dilatation. Magnetic resonant cholangiopancreatography showed abrupt narrowing of distal common bile duct with upstream dilation of biliary duct suggestive of distal cholangiocarcinoma. This case illustrates the important of evaluation for malignant cause of obstructive jaundice in patients with annular pancreas presented with jaundice, anorexia and weight loss.